- Email: [email protected]
Primary Malignant Melanoma of Liver–A Report of 2 Cases
JOURNAL OF CLINICAL AND EXPERIMENTAL HEPATOLOGY
CONFLICTS OF INTEREST The authors have none to declare.
immunotherapy in treatment of PHM has potential for further research.
Corresponding author: Baibaswata Nayak. E-mail: [email protected]
CONFLICTS OF INTEREST
http://dx.doi.org/10.1016/j.jceh.2016.06.112
The authors have none to declare. Corresponding author: Girish P. Veeranna. E-mail: [email protected]
8
http://dx.doi.org/10.1016/j.jceh.2016.06.113
PRIMARY MALIGNANT MELANOMA OF LIVER–A REPORT OF 2 CASES
St John’s Medical College and Hospital, Bengaluru, India
Background: Malignant melanoma is extremely aggressive cancer arising from melanocytes. 90% of all melanomas are of cutaneous origin, although liver is a frequent site of metastasis from melanoma. Primary hepatic melanoma (PHM) is rare. Case Report: In this case report, we present 2 patients of PHM, who came with jaundice, ascites, abdominal pain, for a short duration (1–2 months) and progressively worsened in a short span and finally succumbed. CT scans of both patients revealed diffusely distributed nodules of varying sizes in both the lobes of liver with no evidence of portal hypertension. Liver biopsy showed tumour cells with poor differentiation, which were in nests with prominent melanin deposits. The pigmentation distributed sinusoidally, which was heavy enough to obscure cell morphology. Pigment could be bleached with potassium permanganate. Immunohistochemical stain showed, tumour cells were positive for HMB-45, s100, melanin A. Comprehensive dermatologic, ophtholmological examination revealed no evidence of cutaneous or ocular primary lesion. Other sites like brain, respiratory tract, lung, GIT, were not involved. Our case report showed that, primary malignant melanoma of liver has a histological diversity and immunohistochemical staining may aid in differential diagnosis from other hepatic neoplasms. Both of the above patients died in a short duration after diagnosis, which confirms PHM are extremely aggressive tumours associated with short life span (months). Conclusion: The rare occurrence and aggressive nature of PHM eludes the development of optimal treatment regimen and study of natural history of tumor. The usefulness of chemotherapy, radiation, and
9 DOES DIABETES MELLITUS ALTER THE CLINICAL AND BIOCHEMICAL CHARACTERISTICS OF HEPATOCELLULAR CARCINOMA PATIENTS—A SOUTH INDIAN EXPERIENCE Prasanth Sudheendran, G. Chethan, Nikhil Suraj, Deni Joseph, K. Srijith, M. Ramu, S. Prasanth, A. Shanid, Srijaya Sreesh, Selwyn Noronha, D. Krishnadas
Neoplasms
Girish P. Veeranna, Vishnu Vardhan Reddy, Tarun Sabastian Joseph, Balaji Gurappa, Vishnu Abishek Raju, Mallikarjun Patil, Harshad C. Devarbhavi
Govt. Medical College, Thiruvananthapuram, India
Background and Aims: Recent studies suggested a strong association between diabetes mellitus and Hepatocellular carcinoma (HCC) in males and females independent of the geographic location, alcohol consumption, Hepatitis B or C (HBV or HCV) infection. We tried to find out if diabetes mellitus alter the clinical and biochemical characteristics of HCC patients. Methods: We did a retrospective study of 170 cirrhotic HCC patients attending our department from 2011 to 2015. The various clinical and biochemical factors like age, sex, aetiology, serum alphafetoprotein (AFP), Portal vein thrombosis (PVT) were analysed and correlated with diabetes mellitus by univariate and multivariate analysis with P value <0.05 taken as statistically significant. Results: We had a total of 170 patients with 152 males (89.4%) and 18 females (10.6%) with mean age of patients 56.4 years with a minimum age of 17 years and maximum age of 88 years. Most of the patients belong to CHILD B (38.8%), 42.4% belong to BCLC C status. The most common aetiology was Hepatitis B 25.8%, Alcohol 19.4%, Hepatitis B + Alcohol 17.6%, NASH 12.9% HCV alone 6.4% and others in 17.6% (Fig. 1). By univariate analysis and multivariate analysis age and aetiology were having significant association with diabetes. Analysing the aetiology further we
Journal of Clinical and Experimental Hepatology | July 2016 | Vol. 6 | No. S1 | S63–S73
S67
CONFLICTS OF INTEREST The authors have none to declare.
immunotherapy in treatment of PHM has potential for further research.
Corresponding author: Baibaswata Nayak. E-mail: [email protected]
CONFLICTS OF INTEREST
http://dx.doi.org/10.1016/j.jceh.2016.06.112
The authors have none to declare. Corresponding author: Girish P. Veeranna. E-mail: [email protected]
8
http://dx.doi.org/10.1016/j.jceh.2016.06.113
PRIMARY MALIGNANT MELANOMA OF LIVER–A REPORT OF 2 CASES
St John’s Medical College and Hospital, Bengaluru, India
Background: Malignant melanoma is extremely aggressive cancer arising from melanocytes. 90% of all melanomas are of cutaneous origin, although liver is a frequent site of metastasis from melanoma. Primary hepatic melanoma (PHM) is rare. Case Report: In this case report, we present 2 patients of PHM, who came with jaundice, ascites, abdominal pain, for a short duration (1–2 months) and progressively worsened in a short span and finally succumbed. CT scans of both patients revealed diffusely distributed nodules of varying sizes in both the lobes of liver with no evidence of portal hypertension. Liver biopsy showed tumour cells with poor differentiation, which were in nests with prominent melanin deposits. The pigmentation distributed sinusoidally, which was heavy enough to obscure cell morphology. Pigment could be bleached with potassium permanganate. Immunohistochemical stain showed, tumour cells were positive for HMB-45, s100, melanin A. Comprehensive dermatologic, ophtholmological examination revealed no evidence of cutaneous or ocular primary lesion. Other sites like brain, respiratory tract, lung, GIT, were not involved. Our case report showed that, primary malignant melanoma of liver has a histological diversity and immunohistochemical staining may aid in differential diagnosis from other hepatic neoplasms. Both of the above patients died in a short duration after diagnosis, which confirms PHM are extremely aggressive tumours associated with short life span (months). Conclusion: The rare occurrence and aggressive nature of PHM eludes the development of optimal treatment regimen and study of natural history of tumor. The usefulness of chemotherapy, radiation, and
9 DOES DIABETES MELLITUS ALTER THE CLINICAL AND BIOCHEMICAL CHARACTERISTICS OF HEPATOCELLULAR CARCINOMA PATIENTS—A SOUTH INDIAN EXPERIENCE Prasanth Sudheendran, G. Chethan, Nikhil Suraj, Deni Joseph, K. Srijith, M. Ramu, S. Prasanth, A. Shanid, Srijaya Sreesh, Selwyn Noronha, D. Krishnadas
Neoplasms
Girish P. Veeranna, Vishnu Vardhan Reddy, Tarun Sabastian Joseph, Balaji Gurappa, Vishnu Abishek Raju, Mallikarjun Patil, Harshad C. Devarbhavi
Govt. Medical College, Thiruvananthapuram, India
Background and Aims: Recent studies suggested a strong association between diabetes mellitus and Hepatocellular carcinoma (HCC) in males and females independent of the geographic location, alcohol consumption, Hepatitis B or C (HBV or HCV) infection. We tried to find out if diabetes mellitus alter the clinical and biochemical characteristics of HCC patients. Methods: We did a retrospective study of 170 cirrhotic HCC patients attending our department from 2011 to 2015. The various clinical and biochemical factors like age, sex, aetiology, serum alphafetoprotein (AFP), Portal vein thrombosis (PVT) were analysed and correlated with diabetes mellitus by univariate and multivariate analysis with P value <0.05 taken as statistically significant. Results: We had a total of 170 patients with 152 males (89.4%) and 18 females (10.6%) with mean age of patients 56.4 years with a minimum age of 17 years and maximum age of 88 years. Most of the patients belong to CHILD B (38.8%), 42.4% belong to BCLC C status. The most common aetiology was Hepatitis B 25.8%, Alcohol 19.4%, Hepatitis B + Alcohol 17.6%, NASH 12.9% HCV alone 6.4% and others in 17.6% (Fig. 1). By univariate analysis and multivariate analysis age and aetiology were having significant association with diabetes. Analysing the aetiology further we
Journal of Clinical and Experimental Hepatology | July 2016 | Vol. 6 | No. S1 | S63–S73
S67