Abstract：
Continuously holding its position as the sixth most common cause of cancer and the third leading cause of cancer death, globally, Hepatocellular Carcinoma (HCC) remains as a healthcare priority. Production of various substances may result into systemic or metabolic complications, often known as paraneoplastic phenomena of HCC. A 56-year-old male with history of untreated chronic hepatitis B arrived with generalized weakness and intermittent headache in the last two days prior to admission. Laboratory findings demonstrated elevated hemoglobin (20.5 g/dl), alpha-fetoprotein (29,845 ng/dl), and d-Dimer (2,120 ng/ml) levels. Hypoglycemia (44 mg/dl) was documented with normal basal insulin level, confirming non-islet cell tumor hypoglycemia. Abdominal multiphasic CT-scan demonstrated a large solid lesion involving the whole right liver lobe, hyper-enhanced at arterial phase and wash-out pattern at venous and delayed phases, with portal vein thrombosis; thus, confirming HCC BCLC C. Further examinations revealed hypercellularity from bone marrow biopsy with the absence of JAK2 mutation. He underwent serial phlebotomy and received 80 mg acetylsalicylic acid orally, as well as cytoreductive agent to reduce the risk of thrombosis. Despite applications of different interventions, control of hypoglycemia could not be achieved without parenteral administration of high dextrose load. He was planned to receive oral multikinase inhibitor, however, he passed away due to severe hospital-acquired pneumonia. Paraneoplastic phenomena are common in HCC. Increased risk of blood hyper-viscosity and thrombosis attributed to polycythemia, as well as medical emergency resulting from hypoglycemia showed that both conditions should not be overlooked since they may worsen the patient\'s prognosis.
摘要：
继续保持其作为第六大最常见的癌症原因和第三大癌症死亡原因的地位，全球,肝细胞癌（HCC）仍然是医疗保健的优先事项。各种物质的产生可能导致全身或代谢并发症，通常被称为肝癌的副肿瘤现象。一名56岁的男性，有未经治疗的慢性乙型肝炎病史，在入院前的最后两天出现全身无力和间歇性头痛。实验室结果显示血红蛋白升高（20.5g/dl），甲胎蛋白（29,845ng/dl），和d-二聚体(2,120ng/ml)水平。低血糖症（44mg/dl）记录与正常的基础胰岛素水平，确认非胰岛细胞瘤低血糖。腹部多相CT扫描显示大面积实性病变累及整个右肝叶，在动脉阶段过度增强，在静脉和延迟阶段冲洗模式，门静脉血栓形成；因此，确认HCCBCLCC。进一步检查显示骨髓活检细胞过多，没有JAK2突变。他接受了连续放血，口服80毫克乙酰水杨酸，以及降低血栓形成风险的细胞还原剂。尽管应用了不同的干预措施，如果不进行高葡萄糖负荷的肠胃外给药，则无法实现低血糖的控制。他计划接受口服多激酶抑制剂，然而,他因严重的医院获得性肺炎而去世。副肿瘤现象在HCC中很常见。红细胞增多症引起的血液高粘度和血栓形成的风险增加，以及由低血糖引起的医疗紧急情况表明，这两种情况不应被忽视，因为它们可能会恶化患者的预后。
