Diagnosis and Resection Treatment of Triplet Hepatocellular Carcinomas with a non-B non-C Background in a Middle Aged Man over a Period of 6-years

Abstract

We report a 71-year-old man with non-B non-C chronic liver damage who had been regularly visiting our hospital since he was 38 years of age. He underwent three partial hepatectomies for hepatocellular carcinoma (HCC) diagnosed at 65, 67, and 71 years of age, respectively. A histopathological examination showed moderately-differentiated HCC, and chronic hepatitis with mild fibrosis stage in non-tumor areas. alphafetoprotein (AFP) and PIVKAII were not useful for the early prediction of HCC, but TERT promotor mutation (C228T) in serum cell-free DNA was useful. This is the first report on the importance of long-term follow-up in non-B non-C chronic liver damage, regardless of the fibrosis stage.

TERT Promoter Mutation in Serum Cell-Free DNA Is a Diagnostic Marker of Primary Hepatocellular Carcinoma in Patients with Nonalcoholic Fatty Liver Disease

“…Furthermore, since 2 hotspots of TERT promoter mutations, C228T and C250T, were detected in 94.7 and 5.3% of all HCC patients with identified mutations, respectively, a stronger impact for C228T, compared with C250T, is presumed in HCC [13]. In a recent case report, we indicated that TERT promoter mutation in serum cell-free (cf)DNA might be useful for the early prediction of HCC with non-B non-C chronic liver damage background [14]. However, the value of TERT promoter mutations identified in serum cfDNA, in the early detection of HCC in patients with NAFLD, remains unknown.…”