Abstract
Introduction: Hepatocellular carcinoma (HCC) is a relatively common malignancy and has been associated with Paraneoplastic Syndromes (PNS), including thrombocytosis. The degree of thrombocytosis has been shown to correlate with the severity of the HCC and the level of serum Alpha Fetoprotein (AFP). Thrombocytosis has been proposed by some to be associated with a poorer prognosis in patients with HCC. Case Report: A 64 year old male with a history of hepatocellular carcinoma and liver cirrhosis secondary to chronic hepatitis C was admitted to our hospital for weakness and failure to thrive. His initial laboratory test showed anemia (Hemoglobin of 7.9 gm/dl), thrombocytosis (Platelet count 448K/cmm), elevated transaminases (AST>717, ALT 164U/L) and AFP (273.81 ng/ml). CT abdomen showed multiple large mass lesions in the liver, more prominent in the central portion and the left lobes along with findings suspicious for metastatic lung nodules and omental caking. The patient was deemed a candidate for palliative care after a thorough multi-disciplinary evaluation. Discussion: Hepatocellular carcinoma (HCC) is a common malignancy associated with significant morbidity and mortality. Paraneoplastic syndromes (PNS) like hypercholesterolemia, hypercalcemia, erythrocytosis and thrombocytosis have been reported in HCC. HCC patients with thrombocytosis in most cases have a larger tumor size and higher level of serum AFP, the latter indicating increased biological activity of neoplastic hepatocytes. Thrombopoietin is mainly secreted by liver hepatocytes and stromal cells in the bone marrow. Liver tumors can produce excess thrombopoietin which may represent an underlying mechanism of thrombocytosis (Platelet >400 K/mm3) in HCC. Furthermore, some studies have shown the involvement of platelets in cancer cells growth, and the use of antiplatelet therapy to stop tumor growth. Conclusion: We present a case of HCC patient with thrombocytosis. Thrombocytosis has been associated with larger tumor size and higher serum AFP. Further studies are need to clarify the association between thrombocytosis and poor prognosis in patients with HCC.Figure 1
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
