TY - JOUR T1 - Protective altruistic phlebotomy: hereditary haemochromatosis presenting as hepatocellular carcinoma in a non-cirrhotic 83-year-old man JF - BMJ Case Reports DO - 10.1136/bcr-2016-216649 VL - 2016 SP - bcr2016216649 AU - Kohtaro Ooka AU - Ifeyinwa Onyiuke AU - Xuchen Zhang AU - Tamar Hamosh Taddei Y1 - 2016/09/02 UR - http://casereports.bmj.com/content/2016/bcr-2016-216649.abstract N2 - Hereditary haemochromatosis is a multisystem disorder of iron metabolism. Hepatic manifestations include hepatomegaly, cirrhosis and hepatocellular carcinoma. Hepatocellular carcinoma is almost always preceded by cirrhosis. We present a case of an 83-year-old man without history of liver disease or iron overload who presented with abdominal pain. Workup revealed mildly elevated transaminases, ferritin of 3996 and a solitary liver tumour. Biopsy was consistent with hepatocellular carcinoma in a background of haemosiderosis without cirrhosis. He was diagnosed with hereditary haemochromatosis and hepatocellular carcinoma. He underwent a partial hepatectomy and was started on routine phlebotomy and surveillance imaging. He has improved and has not had signs of recurrence or new complications of haemochromatosis. We suggest a possible reason for his unique and late presentation. ER -