PDF(Pubmed)
Abstract：
Sarcomatoid hepatocellular carcinoma is a rare histologic variant of primary liver cancer comprising of malignant spindle cells and typical hepatocellular carcinoma (HCC). In terms of clinical presentation, they usually exhibit extensive tumor burden due to their larger size and a metastatic disease at the time of diagnosis as compared to conventional HCC. Tumor lysis syndrome is an oncological emergency, usually seen after cytotoxic chemotherapy in haematological malignancies. Here, we highlight a case of 76-year old male with no comorbidities, presenting with an excruciating backache and a paravertebral soft tissue mass and multiple osteolytic lesions, was clinically suspected to be a plasma cell neoplasm. On further evaluation, the patient was diagnosed of a sarcomatoid variant of hepatocellular carcinoma. This report showcases multiple rare findings by the presence of non-specific symptoms, non-cirrhotic liver, normal serum alpha protein levels and the occurrence of a spontaneous tumor lysis syndrome in a solid malignancy.
摘要：
肉瘤样肝细胞癌是原发性肝癌的一种罕见的组织学变体，由恶性梭形细胞和典型的肝细胞癌（HCC）组成。就临床表现而言，与常规HCC相比,由于其体积较大且在诊断时具有转移性疾病,因此通常表现出广泛的肿瘤负担.肿瘤溶解综合征是一种肿瘤急症,通常在血液系统恶性肿瘤的细胞毒性化疗后看到。这里,我们重点介绍一例76岁男性没有合并症,表现为剧烈的背痛，椎旁软组织肿块和多个溶骨性病变，临床怀疑是浆细胞肿瘤。在进一步评估中，该患者被诊断为肝细胞癌的肉瘤样变异型。这份报告展示了存在非特异性症状的多种罕见发现，非肝硬化,正常的血清α蛋白水平和实体恶性肿瘤中自发性肿瘤溶解综合征的发生。
