title: Hepatocellular carcinoma in hepatitis-negative patients with thalassemia intermedia: a closer look at the role of siderosis.
abstract: Patients with thalassemia are often exposed to several risk factors for developing hepatocellular carcinoma (HCC) due to their repeated transfusions. However, even transfusion-independent patients with thalassemia intermedia (TI) can develop HCC, which is mainly attributed to a state of iron overload. We report here two cases and review the literature for the association between TI and HCC. Along with our cases, a total of 36 cases of HCC in thalassemic patients were reported in the literature. Of these, 22 (61%) were TI patients with 6 (27%) of them being hepatitis B and C negative. There was no consistency in their characteristics; therefore, we recommended screening thresholds for HCC in TI patients based on their total liver iron concentration (LIC).
authors.affiliation: Department of Internal Medicine, Division of Hematology & Oncology, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Maakaron
authors.forename: Maria Domenica
authors.initials: MD
authors.lastname: Cappellini
authors.forename: Giovanna
authors.initials: G
authors.lastname: Graziadei
authors.forename: Jad Bou
authors.initials: JB
authors.lastname: Ayache
authors.forename: Ali T
authors.initials: AT
authors.lastname: Taher
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000209:etiology*; D006411:Hematopoiesis, Extramedullary; D006801:Humans; D019190:Iron Overload / Q000150:complications*; D008099:Liver / Q000378:metabolism / Q000473:pathology; D008113:Liver Neoplasms / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D065227:Transfusion Reaction; D017086:beta-Thalassemia / Q000150:complications*