Hepatocellular carcinoma complicated by acute promyelocytic leukemia: a case report

Abstract

A 45-year-old man was referred to our hospital because of pancytopenia and jaundice. He was diagnosed with acute promyelocytic leukemia (APL) because blast-like cells were detected in the peripheral blood and bone marrow accompanied by promyelocytic leukaemia-retinoic acid receptor alpha fusion gene. In addition, contrast-enhanced computed tomography and upper endoscopy revealed hemobilia caused by hepatocellular carcinoma (HCC). Remission induction therapy for APL using all-trans-retinoic acid was effective and hematological remission was confirmed 1 month after the admission. Because hemobilia caused by HCC spontaneously arrested, transarterial chemoembolization (TACE) for HCC was subsequently conducted. Although the patient maintained hematological remission of APL in response to maintenance and consolidation therapy, TACE was repeatedly performed against recurrent HCC. Because lung metastasis was observed, sorafenib was administered 8 months after the diagnosis. However, he died of HCC rupture 3 months after the start of systemic chemotherapy.