Hepatocellular Carcinoma Associated with Hepatic Sarcoidosis and Budd-Chiari Syndrome: A Case Report and Review of the Literature.
Yuta Minami, Takanobu Iwadare, Yuma Kamijo et al.
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Case in brief
A 71-year-old woman with cutaneous sarcoidosis presented with hepatocellular carcinoma. Evaluation identified Budd-Chiari syndrome, indicating hepatic venous outflow obstruction, and hepatic granulomas with advanced fibrosis. The report describes HCC in the setting of both hepatic sarcoidosis and Budd-Chiari syndrome; the abstract does not report treatment or subsequent outcome.
What made this case unusual
The notable finding was HCC occurring alongside hepatic sarcoidosis and Budd-Chiari syndrome, a coexistence the authors describe as extremely rare and not previously reported with HCC.
Diagnostic / clinical pearl
In a patient with sarcoidosis and HCC, assess for hepatic involvement and venous outflow obstruction; this case documented both hepatic granulomas with advanced fibrosis and Budd-Chiari syndrome.
Why it matters
The authors suggest hepatic sarcoidosis and Budd-Chiari syndrome may contribute additively or synergistically to a pro-carcinogenic hepatic environment, though a single case cannot establish causation.