title: Budd-Chiari syndrome and hepatocellular carcinoma: a case report and review of the literature.
abstract: Acid suppression medications have become A 62-yr-old woman with a long-standing history of presumed cryptogenic cirrhosis was referred for evaluation of an elevated bilirubin level. Workup showed an elevated alpha-fetoprotein level, and a mass in the liver was detected by imaging studies; this was confirmed as hepatocellular carcinoma by biopsy. Her past medical history was significant for a portocaval shunt procedure 30 yr prior; a wedge biopsy obtained at that time had been interpreted as postnecrotic cirrhosis, but upon current review, lesions of acute and chronic venous outflow obstruction consistent with Budd-Chiari syndrome were noted. This case is unusual in two aspects: the patient survived 30 yr after shunt surgery with undiagnosed Budd-Chiari syndrome; and the association of Budd-Chiari syndrome with subsequent hepatocellular carcinoma is uncommon.
authors.affiliation: Department of Pathology, Division of Gastroenterology and Hepatology, Saint Louis University Liver Center, Saint Louis University School of Medicine, St. Louis, Missouri 63110-0250, USA.
authors.forename: Necat
authors.initials: N
authors.lastname: Havlioglu
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Brunt
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Bacon
mesh_terms: D006502:Budd-Chiari Syndrome / Q000150:complications*; D006528:Carcinoma, Hepatocellular / Q000150:complications*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications*; D008875:Middle Aged