Resected Hepatocellular Carcinoma in a Patient with Crohn’s Disease on Azathioprine
Hepatocellular carcinoma rarely occurs in patients without underlying cirrhosis or liver disease. While inflammatory bowel disease has been linked to certain forms of liver disease, hepatocellular carcinoma is exceedingly rare in these patients. We report the twelfth case of hepatocellular carcinoma...
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Format: | Article |
Language: | English |
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Karger Publishers
2016-05-01
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Series: | Case Reports in Gastroenterology |
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Online Access: | http://www.karger.com/Article/FullText/444012 |
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author | Valérie Heron Kyle Joshua Fortinsky Gillian Spiegle Nir Hilzenrat Andrew Szilagyi |
author_facet | Valérie Heron Kyle Joshua Fortinsky Gillian Spiegle Nir Hilzenrat Andrew Szilagyi |
author_sort | Valérie Heron |
collection | DOAJ |
description | Hepatocellular carcinoma rarely occurs in patients without underlying cirrhosis or liver disease. While inflammatory bowel disease has been linked to certain forms of liver disease, hepatocellular carcinoma is exceedingly rare in these patients. We report the twelfth case of hepatocellular carcinoma in a patient with Crohn’s disease. The patient is a 61-year-old with longstanding Crohn’s disease who was treated with azathioprine and was found to have elevated liver enzymes and a new 3-cm liver mass on ultrasound. A complete workup for underlying liver disease was unremarkable and liver biopsy revealed hepatocellular carcinoma. The patient underwent a hepatic resection, and there is no evidence of recurrence at the 11-month follow-up. The resection specimen showed no evidence of cancer despite the initial biopsy revealing hepatocellular carcinoma. This case represents the third biopsy-proven complete spontaneous regression of hepatocellular carcinoma. Although large studies have failed to show a definite link between azathioprine and hepatocellular carcinoma, the relationship remains concerning given the multiple case reports suggesting a possible association. Clinicians should exercise a high degree of suspicion in patients with Crohn’s disease who present with elevated liver enzymes, especially those on azathioprine therapy. |
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institution | Directory Open Access Journal |
issn | 1662-0631 |
language | English |
last_indexed | 2024-12-13T08:28:56Z |
publishDate | 2016-05-01 |
publisher | Karger Publishers |
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series | Case Reports in Gastroenterology |
spelling | doaj.art-9e272f9bf4784fe0921de7de9c4fb5aa2022-12-21T23:53:49ZengKarger PublishersCase Reports in Gastroenterology1662-06312016-05-01101505610.1159/000444012444012Resected Hepatocellular Carcinoma in a Patient with Crohn’s Disease on AzathioprineValérie HeronKyle Joshua FortinskyGillian SpiegleNir HilzenratAndrew SzilagyiHepatocellular carcinoma rarely occurs in patients without underlying cirrhosis or liver disease. While inflammatory bowel disease has been linked to certain forms of liver disease, hepatocellular carcinoma is exceedingly rare in these patients. We report the twelfth case of hepatocellular carcinoma in a patient with Crohn’s disease. The patient is a 61-year-old with longstanding Crohn’s disease who was treated with azathioprine and was found to have elevated liver enzymes and a new 3-cm liver mass on ultrasound. A complete workup for underlying liver disease was unremarkable and liver biopsy revealed hepatocellular carcinoma. The patient underwent a hepatic resection, and there is no evidence of recurrence at the 11-month follow-up. The resection specimen showed no evidence of cancer despite the initial biopsy revealing hepatocellular carcinoma. This case represents the third biopsy-proven complete spontaneous regression of hepatocellular carcinoma. Although large studies have failed to show a definite link between azathioprine and hepatocellular carcinoma, the relationship remains concerning given the multiple case reports suggesting a possible association. Clinicians should exercise a high degree of suspicion in patients with Crohn’s disease who present with elevated liver enzymes, especially those on azathioprine therapy.http://www.karger.com/Article/FullText/444012AzathioprineSpontaneous regressionHepatocellular carcinomaCrohn’s disease |
spellingShingle | Valérie Heron Kyle Joshua Fortinsky Gillian Spiegle Nir Hilzenrat Andrew Szilagyi Resected Hepatocellular Carcinoma in a Patient with Crohn’s Disease on Azathioprine Case Reports in Gastroenterology Azathioprine Spontaneous regression Hepatocellular carcinoma Crohn’s disease |
title | Resected Hepatocellular Carcinoma in a Patient with Crohn’s Disease on Azathioprine |
title_full | Resected Hepatocellular Carcinoma in a Patient with Crohn’s Disease on Azathioprine |
title_fullStr | Resected Hepatocellular Carcinoma in a Patient with Crohn’s Disease on Azathioprine |
title_full_unstemmed | Resected Hepatocellular Carcinoma in a Patient with Crohn’s Disease on Azathioprine |
title_short | Resected Hepatocellular Carcinoma in a Patient with Crohn’s Disease on Azathioprine |
title_sort | resected hepatocellular carcinoma in a patient with crohn s disease on azathioprine |
topic | Azathioprine Spontaneous regression Hepatocellular carcinoma Crohn’s disease |
url | http://www.karger.com/Article/FullText/444012 |
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