title: Unusual presentation of metastatic hepatocellular carcinoma in an HIV/HCV coinfected patient: case report and review of the literature.
abstract: Hepatocellular carcinoma (HCC) is an increasing cause of mortality in human immunodeficiency virus (HIV) seropositive patients. Concurrent infection with HIV may accelerate the progression from cirrhosis to HCC. Viral hepatitis and alcohol abuse are the main risk factors for HCC in developed countries. Exposure to these risk factors is common among HIV-infected patients. We report the case of a 43-year-old woman affected by HCC, with unusual soft tissue metastases (left masseter muscle) and HIV/HCV coinfection. The usual route of metastatic spread from classic HCC is hematogenous, with the most common extrahepatic site being the lung. Our case, besides the unusual distant metastatic site, showed very rapid clinical progression, as has been commonly observed in HIV-infected patients with HCC. The case series of HCC in HIV-positive individuals published to date does not cumulatively exceed 70 subjects.
authors.affiliation: Division of Medical Oncology A, National Cancer Institute, Aviano, Italy.
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Berretta
authors.forename: Ernesto
authors.initials: E
authors.lastname: Zanet
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Di Benedetto
authors.forename: Cecilia
authors.initials: C
authors.lastname: Simonelli
authors.forename: Alessandra
authors.initials: A
authors.lastname: Bearz
authors.forename: Aldo
authors.initials: A
authors.lastname: Morra
authors.forename: Santo
authors.initials: S
authors.lastname: Bonanno
authors.forename: Salvatore
authors.initials: S
authors.lastname: Berretta
authors.forename: Umberto
authors.initials: U
authors.lastname: Tirelli
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications*; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000821:virology; D018450:Disease Progression; D005153:Facial Neoplasms / Q000150:complications / Q000175:diagnosis; D005157:Facial Pain / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D015658:HIV Infections / Q000188:drug therapy; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000821:virology; D008279:Magnetic Resonance Imaging; D008406:Masseter Muscle; D009379:Neoplasms, Muscle Tissue / Q000150:complications / Q000175:diagnosis; D012307:Risk Factors