Levine Jake W, Hawa Fadi, Bloom Patricia P
Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI.
ACG Case Rep J. 2023 Jan 27;10(1):e00967. doi: 10.14309/crj.0000000000000967. eCollection 2023 Jan.
A 67-year-old man with a history of alcohol and hepatitis C-associated cirrhosis is diagnosed with incidental metastatic liver cancer during hospitalization for hepatic encephalopathy. He had 2 LI-RADS-3 (indeterminant) lesions on liver magnetic resonance imaging 3 months prior but had no history of hepatocellular carcinoma and was listed for liver transplant. During inpatient paracentesis, the ascites fluid was bloody, so the abdominal and pelvic computed tomography was performed showing a lytic lesion in the left posterior inferior pubic rami. Alpha fetoprotein was within normal limits. His liver was imaged on several occasions without definite evidence of malignancy. Bone biopsy revealed metastatic hepatocellular carcinoma. On return to baseline mental status, patient endorsed no bony pain.
一名67岁男性，有酒精性和丙型肝炎相关性肝硬化病史，因肝性脑病住院期间被诊断出意外转移性肝癌。3个月前肝脏磁共振成像显示有2个LI-RADS-3（不确定）病变，但既往无肝细胞癌病史，已被列入肝移植名单。住院期间进行腹腔穿刺时，腹水呈血性，因此进行了腹部和盆腔计算机断层扫描，显示左耻骨下支后下部有一个溶骨性病变。甲胎蛋白在正常范围内。他的肝脏多次成像，未发现明确的恶性证据。骨活检显示为转移性肝细胞癌。恢复到基线精神状态后，患者表示无骨痛。
