RT Journal Article
SR Electronic
T1 Protective altruistic phlebotomy: hereditary haemochromatosis presenting as hepatocellular carcinoma in a non-cirrhotic 83-year-old man
JF BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr2016216649
DO 10.1136/bcr-2016-216649
VO 2016
A1 Kohtaro Ooka
A1 Ifeyinwa Onyiuke
A1 Xuchen Zhang
A1 Tamar Hamosh Taddei
YR 2016
UL http://casereports.bmj.com/content/2016/bcr-2016-216649.abstract
AB 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.