Hypercalcemic Encephalopathy in a Patient with Hepatocellular Carcinoma

Tudela, Pere; Soldevila, Berta; Mòdol, Josep María; Domènech, Eugeni

doi:10.1007/s10620-006-9159-4

Cited by 6 publications

(5 citation statements)

References 3 publications

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“…Thus, paraneoplastic hypercalcemia is the most significant contributor to the poor outcome attributed to PNS in general. Furthermore, paraneoplastic hypercalcemia associated with HCC can present as a life-threatening medical emergency [18–20]. …”

Section: Discussionmentioning

confidence: 99%

Epidemiology and Prognosis of Paraneoplastic Syndromes in Hepatocellular Carcinoma

et al. 2013

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Background. Paraneoplastic syndromes (PNS) such as hypercalcaemia, hypercholesterolaemia, and erythrocytosis have been described in hepatocellular carcinoma (HCC). Aims. (1) To examine the prevalence, clinical characteristics, and survival of PNS in HCC patients and (2) to evaluate the extent to which each individual PNS impacts on patient survival. Methods. We prospectively evaluated the prevalence, clinical characteristics, and survival of PNS among 457 consecutive HCC patients seen in our department over a 10-year period and compared them with HCC patients without PNS. Results. PNS were present in 127 patients (27.8%). The prevalence of paraneoplastic hypercholesterolemia, hypercalcemia, and erythrocytosis 24.5%, 5.3%, and 3.9%, respectively. Patients with PNS had significantly higher alpha-fetoprotein levels, more advanced TNM stage, and shorter survival. Among the individual PNS, hypercalcemia and hypercholesterolemia were associated with more advanced disease and reduced survival but not erythrocytosis. On multivariate analysis, the presence of PNS was not found to be an independent prognostic factor for reduced HCC survival. Conclusion. PNS are not uncommon in HCC and are associated with poor prognosis and reduced survival due to their association with increased tumor burden. However, they do not independently predict poor survival. Individual PNS impact differently on HCC outcome; paraneoplastic hypercalcemia in particular is associated with poor outcome.

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Section: Discussionmentioning

confidence: 99%

Epidemiology and Prognosis of Paraneoplastic Syndromes in Hepatocellular Carcinoma

et al. 2013

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“…Reports of HCC patients with paraneoplastic syndrome are not uncommon [1, 2, 3, 4, 5, 6]. Four paraneoplastic syndromes have been reported in a single patient [1].…”

Section: Discussionmentioning

confidence: 99%

“…However, their prognosis has been poor except for rare successful cases treated with surgery and transarterial chemoembolization [2, 3]. Except for these rare cases, patients have died soon after tumor detection without sufficient therapy [1, 3, 4, 5, 6]. In this report, an aged HCC patient with paraneoplastic syndrome and angina pectoris was treated successfully with combined neoadjuvant CDDP administration and surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Hepatocellular carcinoma (HCC) sometimes manifests with a variety of paraneoplastic syndrome, such as hypoglycemia [1, 2], erythrocytosis [1, 3], hypercalcemia [1, 4, 5], hypercholesterolemia [1], and thrombocytopenia [6]. Although the reported frequency of paraneoplastic syndrome varies from 1 to 40%, most HCC patients with paraneoplastic syndrome have massive tumors and increased levels of α-fetoprotein (AFP) [1, 2, 3, 6].…”

Section: Introductionmentioning

confidence: 99%

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Successful Treatment in a Case of Massive Hepatocellular Carcinoma with Paraneoplastic Syndrome

Tsuchiya¹,

Kubota²,

Takizawa³

et al. 2009

Case Rep Gastroenterol

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Paraneoplastic syndromes of hepatocellular carcinoma (HCC) are not uncommon. However, the prognosis is poor and follow-up and improvement of paraneoplastic syndromes with treatment have been reported rarely. We report a successful case in an aged man of a massive HCC with paraneoplastic syndrome, treated by combined intraarterial chemotherapy and hepatic resection. Paraneoplastic syndrome (erythrocytosis and hyperlipidemia) was monitored throughout the treatment and erythropoietin (EPO) mRNA also was analyzed in the resected liver. The hemoglobin level and serum levels of EPO and total cholesterol (T-cho) decreased dramatically with treatment, along with a decrease in serum levels of α-fetoprotein and protein induced by vitamin vitamin K absence II (PIVKA-II). Semiquantitative reverse transcription polymerase chain reaction (RT-PCR) revealed that the residual cancer expressed EPO RNA but the nontumor tissue did not. This was a rare case of paraneoplastic syndrome of HCC that was treated successfully. This case indicates that paraneoplastic syndrome reflected tumor progression and that serum levels of both EPO and T-cho might be used as tumor markers.

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“…Hypercaclemic coma can occur in patients with HCC and it can be confused with hepatic encephalopathy [52].…”

Section: Frequency Of Metastases In Different Sites (%)mentioning

confidence: 99%

Signs and Symptoms

Barghini¹,

Donnini²,

Uzzau³

et al. 2013

Hepatocellular Carcinoma - Future Outlook

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Hypercalcemic Encephalopathy in a Patient with Hepatocellular Carcinoma

Cited by 6 publications

References 3 publications

Epidemiology and Prognosis of Paraneoplastic Syndromes in Hepatocellular Carcinoma

Epidemiology and Prognosis of Paraneoplastic Syndromes in Hepatocellular Carcinoma

Successful Treatment in a Case of Massive Hepatocellular Carcinoma with Paraneoplastic Syndrome

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