Cirrhosis and hepatocellular carcinoma in the setting of hemochromatosis
Presentation
Bleeding esophageal varices.
Patient Data
Cirrhotic appearance of the liver with several masses and nodules in the right lobe suggesting multifocal HCC. Thrombosis of the portal vein, also involving intrahepatic branches in the right lobe. Signs of chronic portal hypertension: gastric and esophageal varices, ascites. Atrophic pancreas.
Cirrthotic appearance of the liver with diffuse signal loss due to iron deposition. Several masses and nodules in the right hepatic lobe suggesting multifocal HCC. Thrombosis of the portal vein, also involving intrahepatic branches in the right lobe. Signs of chronic portal hypertension: gastric and esophageal varices, ascites. Atrophic pancreas.
Case Discussion
This elderly patient presented with upper GI bleeding from ruptured esophageal varices. Blank medical history, "never went to the doctor". Imaging shows hemochromatosis and cirrhosis of the liver, as well as several liver masses and nodules. There is also portal vein thrombosis with extensive involvement of intrahepatic branches in the right lobe. Biopsy of the largest mass revealed hepatocellular carcinoma (HCC). There is extensive literature linking hemochromatosis to liver cirrhosis and also HCC.
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