Title: A Rare Presentation of Hepatocellular Carcinoma as Dysphagia
Authors: Dr Hariprasad Potta, Dr A Sadgunarao, Dr NOA Sasikiran
DOI: https://dx.doi.org/10.18535/jmscr/v7i11.71
Abstract
Hepato Cellular Carcinoma (HCC) rarely presents as Dysphagia. A case of 62 yr old male presented with one month history of progressive dysphagia for solids and liquids and is investigated accordingly. UGI endoscopy shown friable growth at the level of GE junction for which biopsy was done. Interestingly biopsy report shown pleomorphic hepatocytes with vesicular nucleus with prominent nucleoli suggestive of HCC. Later HCC is confirmed. As patient was already in BCLC stage D with performance status of ECOG 3 and Child Pugh Score (CPS) of 5 and patient was offered the option of metallic stent for relief of dysphagia. Hence HCC should be considered as a possibility in progressive dysphagia.
References
- Yang PM, Sheu JC, Yang TH, Chen DS, Yu JY, Lee CS, Hsu HC, Sung JL. Metastasis of hepatocellular carcinoma to the proximal jejunum manifested by occult gastrointestinal bleeding. Am J Gastroenterol 1987;82:165-167.
- Lynch P, Green L, Jordan PH, Graham DY. Hepatocellular carcinoma metastatic to the stomach presentingas bleeding multiple craterogenic ulcers. Am JGastroenterol 1989;84:653-655.
- Sung JL, Wang TH, Yu JY. Clinical study on primarycancer of the liver in Taiwan. Am J Dig Dis 1967;12:1036-1049
- Chen LT, Chen CY, Jan CM, Wang WM, Lan TS, et al. (1990) Gastrointestinal tract involvement in hepatocellular carcinoma: clinical, radiological and endoscopic studies. Endoscopy 22: 118-123.
- Llovet JM, Di Bisceglie AM, Bruix J, Kramer BS, Lencioni R, et al. (2008) Design and endpoints of clinical trials in hepatocellular carcinoma. J Natl Cancer Inst 100:698-711.
- Sleisenger and Fordtan’s Gastrointestinal & Live disease, Pathophsyiogy/ Diagnisis/ Management, 10th edition