Acute myeloid leukemia masquerading as hepatocellular carcinoma Journal Article
| Authors: | Abu-Zeinah, G. F.; Weisman, P.; Ganesh, K.; Katz, S. S.; Dogan, A.; Abou-Alfa, G. K.; Stein, E. M.; Jarnagin, W.; Mauro, M. J.; Harding, J. J. |
| Article Title: | Acute myeloid leukemia masquerading as hepatocellular carcinoma |
| Abstract: | Hepatocellular carcinoma (HCC) is often diagnosed on the basis of high quality imaging without a biopsy in the cirrhotic liver. This is a case of a 64-year-old Caucasian man with no history of liver disease or cirrhosis that presented with fatigue, weight loss, and abdominal distension and was found to have a large, isolated liver mass with arterial enhancement and portal venous washout on triple-phase computed tomography (CT) suspicious for HCC. The patient was initially referred for a surgical evaluation. Meanwhile, he developed fevers, pancytopenia, and worsening back pain, and a subsequent spinal MRI revealed a heterogeneous bone marrow signal suspicious for metastatic disease. A bone marrow biopsy that followed was diffusely necrotic. A core biopsy of the patient's liver mass was then performed and was diagnostic of acute monocytic-monoblastic leukemia. Findings from peripheral flow cytometry and a repeat bone marrow biopsy were also consistent with this diagnosis, and induction chemotherapy with cytarabine and idarubicin was initiated. This case describes a rare presentation of myeloid sarcoma (MS) as an isolated, hypervascular liver mass that mimics HCC in its radiographic appearance. Due to the broad differential for a liver mass, a confirmatory biopsy should routinely be considered prior to surgical intervention. © 2016. Journal of Gastrointestinal Oncology. |
| Keywords: | adult; cancer chemotherapy; human tissue; middle aged; gene mutation; fatigue; case report; liver cell carcinoma; liver cirrhosis; cytarabine; flow cytometry; nuclear magnetic resonance imaging; stem cell factor receptor; computer assisted tomography; weight reduction; calcium blood level; aspartate aminotransferase blood level; aspartate aminotransferase; fluorescence in situ hybridization; bone marrow biopsy; acute myeloblastic leukemia; liver surgery; lactate dehydrogenase; idarubicin; lactate dehydrogenase blood level; caucasian; cd33 antigen; alpha fetoprotein; abdominal distension; cd163 antigen; cd68 antigen; ammonia; ammonia blood level; microsomal aminopeptidase; calcium ion; cd56 antigen; acute myeloid leukemia; lysozyme; human; male; article; hepatocellular carcinoma (hcc); myeloid sarcoma (ms) |
| Journal Title: | Journal of Gastrointestinal Oncology |
| Volume: | 7 |
| Issue: | 3 |
| ISSN: | 2078-6891 |
| Publisher: | Pioneer Bioscience Publishing Company |
| Date Published: | 2016-06-01 |
| Start Page: | E31 |
| End Page: | E35 |
| Language: | English |
| DOI: | 10.21037/jgo.2015.12.01 |
| PROVIDER: | scopus |
| PMCID: | PMC4880775 |
| PUBMED: | 27284485 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 6 December 2016 -- Source: Scopus |
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