Hepatocellular carcinoma developed in a patient with chronic hepatitis C after the disappearance of hepatitis C virus due to interferon therapy.
A 62 year-old man was admitted to Asahikawa Medical College Hospital. Injection therapy of natural interferon-alpha was performed against chronic active hepatitis with hepatitis C virus infection. He successfully responded to interferon therapy with normalization of serum transaminases and disappearance of serum hepatitis C virus RNA. The liver function test remained within normal limits and serum hepatitis C virus RNA was not detected throughout the observation period. Three years later, CT examination demonstrated 2 small hepatic masses. Ultrasound-guided biopsy of the hepatic mass demonstrated well-differentiated hepatocellular carcinoma histologically. Laparoscopic examination revealed chronic hepatitis, but neither active inflammation nor cirrhotic changes were noted as an underlying liver disease. In the liver specimen, hepatitis C virus RNA was not detected by RT-PCR. Percutaneous ultrasound-guided ethanol injection therapy achieved complete necrosis of the hepatocellular carcinoma and there was no recurrence of hepatic cancer during the follow-up period. This case suggests that patients with chronic hepatitis C infection, who have complete disappearance of serum hepatitis C virus RNA by interferon therapy, should be followed-up carefully for the potential development of hepatocellular carcinoma.
Inoue
M
M
Third Department of Internal Medicine, Asahikawa Medical College, Hokkaido, Japan.
Ohhira
M
M
Ohtake
T
T
Matsumoto
A
A
Kawashima
T
T
Fujimoto
Y
Y
Hasebe
C
C
Ono
M
M
Kohgo
Y
Y
D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000209:etiology* / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D016174:Hepacivirus / Q000302:isolation & purification; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
D004279:DNA, Viral; D016898:Interferon-alpha