title: Erythrocytosis caused by an erythropoietin-producing hepatocellular carcinoma.
abstract: A case of erythrocytosis caused by a hepatocellular carcinoma (HCC) that produced erythropoietin (Epo) is described. A 64-year-old man, with a huge HCC tumor in the right lobe of the liver, showed a high concentration of hemoglobin and increased levels of serum Epo, alpha-fetoprotein (AFP), and protein induced by vitamin K absence II (PIVKA-II). Right lobectomy of the liver was performed. Histological findings of the specimen showed a moderately differentiated HCC. The existence of Epo was confirmed immunohistochemically only in the tumor tissue and not in the normal liver tissue. Erythrocytosis disappeared and the serum levels of Epo, AFP, and PIVKA-II returned to the normal range after the operation. Within 2 months after the operation, recurrent tumors appeared in the remnant liver, and the patient died 13 months after the operation.
authors.affiliation: Department of Surgery, Osaka City General Hospital, Osaka, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Matsuyama
authors.forename: O
authors.initials: O
authors.lastname: Yamazaki
authors.forename: K
authors.initials: K
authors.lastname: Horii
authors.forename: I
authors.initials: I
authors.lastname: Higaki
authors.forename: S
authors.initials: S
authors.lastname: Kawai
authors.forename: S
authors.initials: S
authors.lastname: Mikami
authors.forename: M
authors.initials: M
authors.lastname: Higashino
authors.forename: H
authors.initials: H
authors.lastname: Oka
authors.forename: T
authors.initials: T
authors.lastname: Nakai
authors.forename: T
authors.initials: T
authors.lastname: Inoue
mesh_terms: D015415:Biomarkers; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D004921:Erythropoietin / Q000096:biosynthesis*; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011086:Polycythemia / Q000209:etiology*; D011498:Protein Precursors / Q000097:blood; D011516:Prothrombin; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D015415:Biomarkers; D011498:Protein Precursors; D000509:alpha-Fetoproteins; D004921:Erythropoietin; C008208:acarboxyprothrombin; D011516:Prothrombin