Wilson Hastalığının Nadir Bir Komplikasyonu: Hepatoselüler Karsinom

Bakır metabolizma bozukluğu olan Wilson hastalığı, klinik spektrumu oldukça geniştir. Birikim yaptığı organa spesifik bulgu vermektedir. Bu hastalar gastroenteroloji polikliniğinde asemptomatik transaminaz yüksekliği ile başvurabileceği gibi, ileri komplikasyonlardan olan siroz ve hepatoselüler karsinom şeklinde de prezente olabilmektedir. Olgu sunumunda siroz nedeniyle takipli olan Wilson hastasının rutin takiplerinde AFP (alfa-feto protein) yüksekliği olması nedeniyle ileri araştırmalar sonucunda HCC (hepatoselüler karsinom) tanısı alan hastayı sunmaktayız.

A Rare Complication of Wilson's Disease: Hepatocellular Carcinoma

Wilson's disease, which is a disorder of copper metabolism, its clinical spectrum is quite wide. It gives specific findings to the organ it accumulates. These patients may present with asymptomatic transaminase elevation in the gastroenterology outpatient clinic, as well as cirrhosis and hepatocellular carcinoma, which are advanced complications. In the case report, we present a patient who was diagnosed with HCC (hepatocellular carcinoma) as a result of advanced research due to the high AFP (alpha-feto protein) during routine follow-up of a Wilson patient who was being followed up due to cirrhosis.

___

  • 1. Poujois A, Woimant F. Wilson’s disease: A 2017 update. Clin Res Hepatol Gastroenterol 2018 Dec;42(6):512–20.
  • 2. Camarata MA, Gottfried M, Rule JA, Ala A, Lee WM, Todd Stravitz R, et al. Outcomes of Acute Liver Injury in Adults Due to Wilson’s Disease: Is Survival Without Transplant Possible? Liver Transplant Off Publ Am Assoc Study Liver Dis Int Liver Transplant Soc 2020 Mar;26(3):330–6.
  • 3. Lucena-Valera A, Perez-Palacios D, Muñoz-Hernandez R, Romero-Gómez M, Ampuero J. Wilson’s disease: Revisiting an old friend. World J Hepatol 2021 Jun 6;13(6):634. 4. Liu J, Luan J, Zhou X, Cui Y, Han J. Epidemiology, diagnosis, and treatment of Wilson’s disease. Intractable Rare Dis Res 2017 Nov; 6(4):249–55.
  • 5. Mulligan C, Bronstein JM. Wilson Disease: An Overview and Approach to Management. Neurol Clin 2020 May; 38(2):417–32.
  • 6. European Association for Study of Liver. EASL Clinical Practice Guidelines: Wilson’s disease. J Hepatol 2012 Mar; 56(3):671–85.
  • 7. Walshe JM, Waldenström E, Sams V, Nordlinder H, Westermark K. Abdominal malignancies in patients with Wilson’s disease. QJM Mon J Assoc Physicians 2003 Sep ;96(9):657–62. 8. 349.pdf [Internet]. [cited 2022 Jul 31]. Available from: https://guncel.tgv.org.tr/journal/33/pdf/349.pdf 9. Roberts EA, Schilsky ML, American Association for Study of Liver Diseases (AASLD). Diagnosis and treatment of Wilson disease: an update. Hepatol Baltim Md 2008 Jun; 47(6):2089–111.
  • 10.Thattil R, Dufour JF. Hepatocellular carcinoma in a non-cirrhotic patient with Wilson’s disease. World J Gastroenterol 2013 Apr 7;19(13):2110–3.
  • 11.van Meer S, de Man RA, van den Berg AP, Houwen RHJ, Linn FHH, van Oijen MGH, et al. No increased risk of hepatocellular carcinoma in cirrhosis due to Wilson disease during long-term follow-up. J Gastroenterol Hepatol 2015 Mar;30(3):535–9.
  • 12.Suriawinata A, Xu R. An update on the molecular genetics of hepatocellular carcinoma. Semin Liver Dis 2004 Feb;24(1):77–88.
  • 13. Agret F, Vallet-Pichard A, Landau A, Carnot F, Pol S. [Late presentation of Wilson’s disease as cirrhosis complicating hepatocellular carcinoma]. Gastroenterol Clin Biol 2003 Jan;27(1):130–1.
  • 14. Xu R, Bu-Ghanim M, Fiel MI, Schiano T, Cohen E, Thung SN. Hepatocellular carcinoma associated with an atypical presentation of Wilson’s disease. Semin Liver Dis 2007 Feb;27(1):122–7.
  • 15.Xu R, Hajdu CH. Wilson Disease and Hepatocellular Carcinoma. Gastroenterol Hepatol 2008 Jun;4(6):438–9.