Development of multicentric hepatocellular carcinoma after completion of interferon therapy

September 17, 2002

Journal of Gastroenterology

ISSN: 0944-1174 (printed version)

ISSN: 1435-5922 (electronic version)

Abstract Volume 37 Issue 8 (2002) pp 663-668

DOI 10.1007/s005350200106

case report: Development of multicentric hepatocellular carcinoma after

completion of interferon therapy

Soo g Kim (1), Toshiyuki Matsuoka (2), Yoko Maekawa (3), Yoshihiko Yano (4),

Susumu Imoto (1), Masatoshi Kudo (5), Shigeyuki Shintani (1), Kenji Ando (1),

Keiji Mita (1), Katsumi Fukuda (1), Toshihiro Koterazawa (1), Miyuki Nakaji (4),

Hirotsugu Ikawa (4), Toshiaki Ninomiya (6), Ke Ih Kim (7), Midori Hirai (8),

Yoshitake Hayashi (4)

(1) Department of Gastroenterology, Kobe Asahi Hospital, 3-5-25 Bouoji-cho,

Nagata-ku, Kobe 653-0801, Japan

(2) Department of Radiology, Osaka City University Medical School, Osaka, Japan

(3) First Department of Surgery, Kobe University School of Medicine, Kobe, Japan

(4) First Department of Pathology, Kobe University School of Medicine, Kobe,

Japan

(5) Department of Gastroenterology, Kinki University School of Medicine,

Osakasayama, Japan

(6) Second Department of Internal Medicine, Kobe University School of Medicine,

Kobe, Japan

(7) Department of Pharmacy, Kobe Asahi Hospital, Kobe, Japan

(8) Department of Clinical Pharmacy, Kobe Pharmaceutical University, Kobe, Japan

Received: December 21, 2000 / Accepted: April 13, 2001

We report a case of multicentric hepatocellular carcinoma that developed in a

74-year-old man 3 and 6 years after interferon (IFN) treatment for chronic

hepatitis C, despite sustained virologic, biochemical, and histological

improvement. Initially, serum hepatitis C virus RNA was positive and the

patients' serum level of alanine aminotransferase (ALT; 82 IU/ml) was abnormal.

Hepatitis B virus (HBV) in the serum was negative for surface antigen, surface

antibody, core antibody, and DNA. The patient was started on 10 × 106

international units (IU) of IFN<alpha>, 3 days a week for a total of 24 weeks.

After the IFN therapy, the patient demonstrated a normal serum ALT level, and

was continuously negative for HCV-RNA, and histology improved from chronic

active hepatitis to chronic persistent hepatitis. Follow-up studies with

ultrasonography (US) every 3 months and computed tomography (CT) every 6 months

revealed no space-occupying lesion (SOL) for 3 years after IFN treatment.

US-guided biopsies of two 15-mm hypoechoic SOLs in segments eight (S8) and seven

(S7) 34 and 74 months, respectively, after IFN treatment showed

well-differentiated hepatocellular carcinoma (HCC). Clinical data, imaging

studies, and histologic examinations showed that both tumors were multicentric

HCC. Further studies may provide insights into the possible role of HCV in

hepatocarcinogenesis in patients demonstrating HCV eradication by IFN treatment.

September 17, 2002