Hepatocellular Carcinoma in a Patient With Crohn’s Disease

Abstract

A 44-year-old woman with a 26-year history of Crohn's disease (CD) presented with intermittent fever, vomiting, and watery diarrhea. Her medication included an elemental diet, mesalazine, and infliximab. Liver profile and viral hepatitis markers were normal. Computed tomography scans showed a hepatic tumor by chance. Serum tumor markers disclosed elevated protein induced by vitamin K absence-II. With a diagnosis of hepatocellular carcinoma (HCC), she underwent a hepatic resection of the tumor, revealing well-tomoderately differentiated HCC. The nontumor region of the liver disclosed the absence of cirrhosis or other diseases. Here, the development of HCC in CD without underlying liver diseases is discussed with a review of the literature.

Management of hepatocellular carcinoma, an important cause of death in Japanese autoimmune hepatitis patients

“…In Japan, steroid-resistant AIH is found in approximately 10% of the cases, where azathioprine is used [ 4 ]. There have been reports of HCC in cases of long-term azathioprine use in Crohn’s disease and other inflammatory bowel diseases [ 25 ]. Azathioprine and AIH carcinogenesis are also of interest; however, in this and previous studies, the association between AIH and carcinogenesis was poor [ 4 ].…”