Hepatocellular carcinoma (HCC) is a severe complication of cirrhosis of whatever etiology, and it affects prognosis. The main causes of cirrhosis are alcoholic liver disease, chronic hepatitis C (HCV) and B virus (HBV) infection, and iron overload. Furthermore, HCC rarely develops in the absence of cirrhosis [1,2]. Due to periodical transfusions, many patients with b-thalassemia are often infected with either HCV, HBV, or both, particularly those born before the 1990s [3]. Despite the introduction of desferrioxamine at the end of the 1970s, cardiac complications continued to be the main cause of death of thalassemics in the second and third decades of life until recently. Very few patients survived long enough to develop HCC. In fact, only one case of HCC had been reported in b-thalassemia [4]. The recent outcome improvement has allowed HCC to develop. A recent multicenter Italian retrospective study identified 23 cases of HCC in thalassemia syndromes [5]. Because of this concern, our policy was a strict HCC ultrasound (US) screening program in all patients with thalassemia syndromes.
Hepatocellular carcinoma on cirrhosis-free liver in a HCV-infected thalassemic.
BORGNA, Caterina;
2005
Abstract
Hepatocellular carcinoma (HCC) is a severe complication of cirrhosis of whatever etiology, and it affects prognosis. The main causes of cirrhosis are alcoholic liver disease, chronic hepatitis C (HCV) and B virus (HBV) infection, and iron overload. Furthermore, HCC rarely develops in the absence of cirrhosis [1,2]. Due to periodical transfusions, many patients with b-thalassemia are often infected with either HCV, HBV, or both, particularly those born before the 1990s [3]. Despite the introduction of desferrioxamine at the end of the 1970s, cardiac complications continued to be the main cause of death of thalassemics in the second and third decades of life until recently. Very few patients survived long enough to develop HCC. In fact, only one case of HCC had been reported in b-thalassemia [4]. The recent outcome improvement has allowed HCC to develop. A recent multicenter Italian retrospective study identified 23 cases of HCC in thalassemia syndromes [5]. Because of this concern, our policy was a strict HCC ultrasound (US) screening program in all patients with thalassemia syndromes.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
