title: Patient with hepatocellular carcinoma related to prior acute arsenic intoxication and occult HBV: epidemiological, clinical and therapeutic results after 14 years of follow-up.
abstract: Little is known about the long-term survivors of acute arsenic intoxication. We present here a clinical case report of a man with chronic hepatitis B virus (HBV) infection who developed hepatocellular carcinoma four years after acute arsenic poisoning. HBsAg was detected in serum in 1990 when he voluntarily donated blood. In 1991, the patient suffered from severe psychological depression that led him to attempt suicide by massive ingestion of an arsenic-containing rodenticide. He survived with polyneuropathy and paralysis of the lower limbs, and has been wheelchair-bound since then. During participation in a follow-up study conducted among HBV carriers, abdominal ultrasound detected a two-centimeter liver mass consistent with hepatocellular carcinoma. The tumor was confirmed by computed tomography (CT) and magnetic resonance image (MRI). Because of his significant comorbidity, the patient received palliative treatment with transarterial lipiodol chemoembolization (TACE) on three occasions (1996, 1997 and 1999). At his most recent visit in May 2005, the patient was asymptomatic, liver enzymes were normal and the tumor was in remission on ultrasound.
authors.affiliation: Department of Gastroenterology, Hospital Universitari de Bellvitge, IDIBELL, Feixa Llarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona, Spain. teresacasanovas@csub.scs.es
authors.forename: Teresa
authors.initials: T
authors.lastname: Casanovas-Taltavull
authors.forename: Josepa
authors.initials: J
authors.lastname: Ribes
authors.forename: Ana
authors.initials: A
authors.lastname: Berrozpe
authors.forename: Sara
authors.initials: S
authors.lastname: Jordan
authors.forename: Aurora
authors.initials: A
authors.lastname: Casanova
authors.forename: Concha
authors.initials: C
authors.lastname: Sancho
authors.forename: Carles
authors.initials: C
authors.lastname: Valls
authors.forename: F Xavier
authors.initials: FX
authors.lastname: Bosch
mesh_terms: D020261:Arsenic Poisoning / Q000150:complications*; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D016461:Chemoembolization, Therapeutic; D005500:Follow-Up Studies; D006509:Hepatitis B / Q000150:complications*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology; D008113:Liver Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D006514:Hepatitis B Surface Antigens