title: Protective altruistic phlebotomy: hereditary haemochromatosis presenting as hepatocellular carcinoma in a non-cirrhotic 83-year-old man.
abstract: Hereditary haemochromatosis is a multisystem disorder of iron metabolism. Hepatic manifestations include hepatomegaly, cirrhosis and hepatocellular carcinoma. Hepatocellular carcinoma is almost always preceded by cirrhosis. We present a case of an 83-year-old man without history of liver disease or iron overload who presented with abdominal pain. Workup revealed mildly elevated transaminases, ferritin of 3996 and a solitary liver tumour. Biopsy was consistent with hepatocellular carcinoma in a background of haemosiderosis without cirrhosis. He was diagnosed with hereditary haemochromatosis and hepatocellular carcinoma. He underwent a partial hepatectomy and was started on routine phlebotomy and surveillance imaging. He has improved and has not had signs of recurrence or new complications of haemochromatosis. We suggest a possible reason for his unique and late presentation.
authors: Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
authors: Kohtaro
authors: K
authors: Ooka
authors: Department of Radiology, VA Connecticut Health System West Haven Campus, West Haven, Connecticut, USA.
authors: Ifeyinwa
authors: I
authors: Onyiuke
authors: Department of Pathology, Yale University, New Haven, Connecticut, USA.
authors: Xuchen
authors: X
authors: Zhang
authors: Department of Internal Medicine-Digestive Diseases, Yale School of Medicine, New Haven, Connecticut, USA Department of Internal Medicine-Digestive Diseases, VA Connecticut Health System West Haven Campus, West Haven, Connecticut, USA.
authors: Tamar Hamosh
authors: TH
authors: Taddei
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000209:etiology* / Q000601:surgery; D006432:Hemochromatosis / Q000150:complications* / Q000628:therapy; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000209:etiology* / Q000601:surgery; D008297:Male; D018962:Phlebotomy / Q000379:methods*