Abstract
The patient was a 53-year-old man who presented with extrapyramidal symptoms from the age of 13, was diagnosed with Wilson's disease at the age of 19, and thereafter had been administered D-penicillamine. From around the age of 35, he had been given cyclosporine for psoriasis vulgaris. A CT scan performed at a previous hospital revealed a hepatic tumor. An abdominal contrast-enhanced CT scan and a Gd-EOB-DTPA-enhanced MRI scan showed a 6-cm tumor with a pattern of early enhancement and washout in the segment 2 of liver. Hepatocellular carcinoma (HCC) was diagnosed. Although he had neurological symptoms such as dysphagia and there was a risk of taking oral cyclosporin, his hepatic function was rated as Child-Pugh A. Because we thought the patient was tolerable for radical resection, and he underwent limited resection of lateral segment. The histopathological diagnosis was moderately differentiated HCC. The underlying liver histology was cirrhosis. Rhodanine staining demonstrated no copper deposits in the hepatic cells. It has been believed that Wilson's disease is rarely associated with HCC, but in this case, a risk of carcinogenesis might increase by association of psoriasis vulgaris and administration of cyclosporine, resulting in development of HCC with cirrhosis.
