Abstract METABOLIC and hematologic abnormalities have been described as manifestations of primary hepatic neoplasms. Erythrocytosis is the most common of these secondary manifestations, occurring in 11.7% of patients in one series.1 Less commonly, hypercholesterolemia,2,3 osteoporosis,2,4 porphyria,5 precocious puberty,6 and hypoglycemia7 have been reported. This report describes the occurrence of erythrocytosis and hyperlipemia in a young adult with hepatic cell carcinoma. Studies were done to clarify the mechanisms of these abnormalities. Awareness of the unusual metabolic alterations associated with hepatoma may assist in the diagnosis of obscure hepatic disease. Methods Routine laboratory procedures including determinations of liver function and cholesterol levels8 were performed by the clinical chemistry laboratory by standard methods. Plasma volume was determined by the isotope dilution technique using iodinated I 131 serum albumin (human). Red blood cell volume was calculated from the hematocrit and the determined plasma volume. Serum and saline extracted References 1. Kan, Y.W., et al: Further Observations on Polycythemia in Hepatocellular Carcinoma , Blood 18:592, 598, 1961. 2. Hansen, A.E.; Ziegler, M.R.; and McQuarrie, I.: Disturbance of Osseous and Lipid Metabolism in a Child With Primary Carcinoma of the Liver , J Pediat 17:9-30, 1940.Crossref 3. Viallet, A.; Benhamou, J.-P.; and Fauvert, R.: Primary Carcinoma of the Liver and Hyperlipemia , Canad Med Assoc J 86:1118-1122, 1962. 4. Teng, C.T., et al: Liver Diseases and Osteoporosis in Children , J Pediat 59:684-702, 1961.Crossref 5. Tio, T.H., et al: Acquired Porphyria From a Liver Tumor , Clin Sci 16:517-528, 1957. 6. Reeves, R.L.; Tesluk, H.; and Harrison, C.E.: Precocious Puberty Associated With Hepatoma , J Clin Endocr 19:1651-1660, 1959.Crossref 7. Landau, B.R., et al: Mechanism of Hepatoma Induced Hypoglycemia , Cancer 15:1188-1196, 1962.Crossref 8. Zak, B., et al: Rapid Estimation of Free and Total Cholesterol , Amer J Clin Path 24:1307-1315, 1954. 9. Rosse, W.F., and Waldmann, T.A.: " Bioassays of Erythropoietin A: Method Using Transfused Polycythemic Mouse ," in Sunderman, F.W., and Sunderman, F.W., Jr. (eds.): Hemoglobin, Its Precursors and Metabolites , Philadelphia: J. B. Lippincott Co., 1964, p 269. 10. Amenta, J.S.: A Rapid Chemical Method for Quantification of Lipids Separated by Thin-layer Chromatography , J Lipid Res 5:270, 1964. 11. Bartlett, G.R.: Phosphorus Assay in Column Chromatography , J Biol Chem 234:466-468, 1959. 12. Lees, R.S., and Hatch, F.T.: Sharper Separation of Lipoprotein Species by Paper Electrophoresis in Albumin-containing Buffer , J Lab Clin Med 61:518-528, 1963. 13. Donati, R.M., et al: Erythrocythemia and Neoplastic Tumors , Ann Intern Med 58:47-55, 1963.Crossref 14. Lipsett, M.B., et al: Humoral Syndromes Associated With Nonendocrine Tumors , Ann Intern Med 61:733-756, 1964.Crossref 15. Waldmann, T.A.: " Polycythemia and Cancer ," Fifth National Cancer Conference Proceedings , Philadelphia: J. B. Lippincott Co., 1964, p 437. 16. Brownstein, M.H., and Ballard, H.S.: Hepatoma Associated With Erythrocytosis , Amer J Med 40:204-210, 1966.Crossref 17. Nakao, K., et al: Erythrocytosis Associated With Carcinoma of the Liver (With Erythropoietin Assay of Tumor Extract) , Amer J Med Sci 251: 161-165, 1966.Crossref 18. Lieber, C.S., and Spritz, N.: Effects of Prolonged Ethanol Intake in Man: Role of Dietary, Adipose and Endogenously Synthesized Fatty Acids in the Pathogenesis of the Alcoholic Fatty Liver , J Clin Invest 45:1400-1411, 1966.Crossref 19. Fredrickson, D.S., and Lees, R.S.: " Familial Hyperlipoproteinemia ," in Stanbury, J.B., Wyngaarden, J.B., and Fredrickson, D.S. (eds.): The Metabolic Basis of Inherited Disease , New York: McGraw-Hill Book Co., 1966, p 429.
Archives of Internal Medicine – American Medical Association
Published: Dec 1, 1967