Ebru ALTINDAL, Murat ATMACA, Enver AYTEMİZ, Hüseyin AKDENİZ, Ahmet Cumhur DÜLGER

A Case of fibrolamellar hepatocellular carcinoma presented with elevated serum vitamın b12 levels

Karaciğer fibrolamellar karsinomu hepatosellüler karsinomun bir varyantıdır. Tümör genç insanlarda nisbi olarak daha sık görülür ve cinsiyet baskınlığı yoktur. Hastalık karın ağrısı, kilo kaybı ve yorgunluk ile ortaya çıkar. İnsan serumunda yüksek kobalamin düzeylerinin saptandığı fibrolamellar karsinom olguları yayınlanmıştır. Bundan dolayı yüksek serum kobalamin düzeyleri iyi bir tümör markırı olarak kullanılabilir. Haptocorrin düzeylerinin değişikliği bu fenomende önemli bir rol oynar. Erken evre tümörde cerrahi rezeksiyon uygun bir seçenektir, tek ajanlı kemoterapi rejimleri de kullanılabilir. Bizler; yüksek vitamin B12 düzeyleri ile ortaya çıkan ve haftada üç kez subkutan rekombinan interferon α-2b verilen bir hastayı sunuyoruz.

Yüksek vitamin b12 düzeyleri ile ortaya çıkan bir fibrolamellar hepatosellüler karsinom olgusu

Fibrolamellar carcinoma of the liver is a variant of hepatocellular carcinoma. It is relatively common in young people and has equal gender distribution. The disease presents as abdominal pain, weight loss and malaise. In several reports of fibrolamellar liver tumors, high cobalamin level has been demonstrated in the human s serum. Therefore, serum cobalamin has been found as a good tumour marker for fibrolamellar hepatocellular carcinoma. Elevated production or decreased elimination of haptocorrin may play an important role for this phenomen. For early fibrolamellar carcinoma, surgical resection, when feasible, is the gold standart for the treatment. In advanced stage of the disease; single-modality treatments (recombinant interferon α-2b or sorafenib) can be tried. Herein, we report a case of metastatic fibrolamellar hepatocellular carcinoma that was presented with high vitamin B12 levels and continued subcutaneous recombinant interferon α-2b thrice-weekly.

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