Kanzo

Original Article

The relationship between the core protein polymorphism and the development of hepatocellular carcinoma in patients chronically infected with hepatitis C virus genotype 1b

Michiko Shindo, Ahmed El-Shamy, Tadao Okuno, Haku Hotta

2012 Volume 53 Issue 9 Pages 541-548
Published: 2012
Released on J-STAGE: September 28, 2012

DOIhttps://doi.org/10.2957/kanzo.53.541

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The aim of this study was to determine whether amino acid residues 70 and 91 of the core protein of hepatitis C virus (HCV) genotype 1b are associated with the development of hepatocellular carcinoma (HCC), and whether this region could change over time with the development of HCC. A total of 49 paired serum samples from patients who had been followed up for more than 7 years from the time of chronic hepatitis C (pre HCC sample) before IFN treatment until the time of the development of HCC (post HCC samples) were examined for mutations in the core protein of HCV. A total of 50 sera from 50 pre-IFN treatment chronic hepatitis C patients who also had been followed up for more than 10 years and did not develop HCC were used as a control.
The incidence of the HCV core protein mutation at position 70 (Gln⁷⁰) was significantly higher in the HCC group than in the control (p=0.003), while the residue at 91 (non-Leu⁹¹) did not significantly differ between the two groups. Sequence patterns of the core protein at positions 70 and 91 did not significantly change over time before and after the occurrence of HCC in the HCC group. The present study suggests that the residue of the HCV core protein at position 70, but not 91, was significantly associated with the development of HCC, and that the residue did not change over time with the development of HCC.

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Case Reports

A case of the liver metastasis arising from the gastrointestinal stromal tumor of the duodenum with neurofibromatosis type 1 that presented cystic dengeneration and showed interesting pathological findings

Hikaru Oguri, Kazuto Kakuma, Shinichi Hayashi

2012 Volume 53 Issue 9 Pages 549-557
Published: 2012
Released on J-STAGE: September 28, 2012

DOIhttps://doi.org/10.2957/kanzo.53.549

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A 74-years-old woman with neurofibromatosis type 1 was admitted to our hospital for liver injury. Abdominal computed tomography revealed multiple cystic tumors in the liver and a solid tumor on the second portion of the duodenum. Histological findings of the biopsied specimen of the duodenal tumor showed spindle shaped tumor cells, which were immunohistochemically positive for KIT, the duodenal tumor was diagnosed as gastrointestinal stromal tumor. On the other hand, the biopsied specimen of the liver tumor showed hepatocyte-like tumor cells, which were different from the duodenal tumor. However, hepatic tumor cells were also immunohistochemically positive for KIT, the hepatic tumors were diagnosed as liver metastasis arising from the duodenal gastrointestinal stromal tumor. For this case, it is interesting that pathological and radiological findings of the metastatic lesion were different from the primary lesion.

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A surgical case of solitary lymph node metastatic recurrence of combined hepatocellular and cholangiocarcinoma after hepatectomy

Kazuhiro Suzumura, Tadamichi Hirano, Nobukazu Kuroda, Yuji Iimuro, Ami ...

2012 Volume 53 Issue 9 Pages 558-563
Published: 2012
Released on J-STAGE: September 28, 2012

DOIhttps://doi.org/10.2957/kanzo.53.558

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A 79-year-old woman who was undergone hepatic resection for combined hepatocellular and cholangiocarcinoma. During follow-up, her serum AFP and PIVKA-II were found to be elevated. Abdominal computed tomography (CT) showed a solitary tumor. She had no recurrence in the liver or other organs. Under a diagnosis of solitary lymph node metastatic recurrence, we excised the lymph node. Histological examination showed lymph node metastasis of HCC component of combined hepatocellular and cholangiocarcinoma. Serum AFP and PIVKA-II decreased postoperatively. No signs of recurrence were seen in follow-up 4 months after surgery. We report a surgical case of solitary lymph node metastatic recurrence of combined hepatocellular and cholangiocarcinoma after hepatectomy with a review of the literature.

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A case of hepatocellular carcinoma obtained marked anti-tumor effect by low dose sorafenib after the progression of the disease during high-dose of sorafenib

Shinji Oe, Michihiko Shibata, Yuichi Honma, Masaaki Hiura, Shintaro Ab ...

2012 Volume 53 Issue 9 Pages 564-569
Published: 2012
Released on J-STAGE: September 28, 2012

DOIhttps://doi.org/10.2957/kanzo.53.564

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A 79-year-old woman with hepatocellular carcinomas (HCCs) were treated by transcatheter arterial chemoembolization (TACE). But she was considered as TACE-refractory because of increasing tumors. Her liver function was Child-Pugh grade A and she was treated with sorafenib at an initial dose of 800 mg/day. Seven days after the initiation, the dose was reduced to 400 mg/day because of hand-foot syndrome. Computed tomography (CT) after 2 months demonstrated progression of HCCs, and therapeutic effect (TE) was considered as progressive disease (PD) by Response Evaluation Criteria in Solid Tumors (RESIST). The dose was further reduced to 200 mg/day because of re-appearance of hand-foot syndrome after 2.5 months. She had continued sorafenib treatment, and after 4 months CT showed marked reduction of HCCs, and tumor markers were also decreased. Sorafenib treatment is continued with the dose of 200 mg/day, and the TE has been maintained partial remission (PR) for 9 months.

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A case of pseudoaneurysm of a collateral hepatic artery

Tatsuma Sakaguchi, Masaki Kaibori, Morihiko Ishizaki, Kosuke Matsui, H ...

2012 Volume 53 Issue 9 Pages 570-574
Published: 2012
Released on J-STAGE: September 28, 2012

DOIhttps://doi.org/10.2957/kanzo.53.570

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A 67-year-old man was referred to our hospital for investigation of a hepatic tumor. He had undergone cholecystectomy at age 38 years and was HCV-Ab positive. Dynamic CT scan revealed a mass in the hepatic portal region, which showed vascular enhancement. Angiography showed a collateral artery arising from the left hepatic artery to supply the right hepatic lobe, and absence of a right hepatic artery. An 8 mm aneurysm arising from the collateral artery was detected. As the collateral artery was narrow, transcatheter arterial embolization could not be undertaken. At surgery, the aneurysm was detected on the right side of the umbilical portion of the liver, and was treated by ligation. Pathological examination showed hypertrophy of the tunica intima and atrophy of the tunica media. A pathological diagnosis of idiopathic pseudoaneurysm was made. We report herein a rare case of a collateral hepatic artery aneurysm treated by ligation.

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