Kusumi Yuriko, Hasebe Takumu, Hayashi Manami, Kamikokura Yuki, Otake Shin, Hayashi Hidemi, Ota Yu, Nakajima Shunsuke, Aso Kazunobu, Sawada Koji, Tanino Mishie, Fujiya Mikihiro
Department of Internal Medicine, Division of Gastroenterology, Asahikawa Medical University, Japan.
Department of Diagnostic Pathology, Asahikawa Medical University Hospital, Japan.
Intern Med. 2025 Oct 1;64(19):2839-2845. doi: 10.2169/internalmedicine.5081-24. Epub 2025 Mar 22.
A man in his 70s with antiphospholipid syndrome (APS) presented with a hepatic mass. Initial imaging suggested hepatic infarction, as the liver tumor markers were normal, and coagulation tests indicated a hypercoagulable state. Three years later, follow-up imaging revealed tumor enlargement, leading to a biopsy-confirmed hepatocellular carcinoma diagnosis. Transarterial embolization was performed followed by lenvatinib therapy. The patient achieved complete response with no recurrence for over eight months. This case highlights the potential of APS to contribute to liver carcinogenesis in non-cirrhotic patients and illustrates the need for individualized treatment strategies.
一名70多岁的抗磷脂综合征(APS)男性患者出现肝脏肿块。初始影像学检查提示肝梗死,因为肝脏肿瘤标志物正常,凝血检查显示高凝状态。三年后,随访影像学检查显示肿瘤增大,活检确诊为肝细胞癌。进行了经动脉栓塞术,随后采用乐伐替尼治疗。患者实现完全缓解,超过八个月无复发。该病例突出了APS在非肝硬化患者肝脏致癌中的潜在作用,并说明了个性化治疗策略的必要性。