Hepatocellular Carcinoma Associated with Diabetes and Hyperaldosteronemia in a Young Adult Patient

Junpei Yamaguchi, Tsuyoshi Sano, Kazuaki Shimada, Yoshihiro Sakamoto, Satoshi Nara and Tomoo Kosuge

Hepatobiliary and Pancreatic Surgery Division, National Cancer Center Hospital

We present a case of hepatocellular carcinoma (HCC) complicated by glucose intolerance and hyperaldosteronemia in a young adult patient without HBV or HCV infection. A 25-year-old man presented with abdominal fullness and leg edema and was diagnosed as having a liver tumor and diabetes. Laboratory examination revealed an elevated serum aldosterone level (421 ng/dl) and a urinary 17-ketosteroid (17-KS) level of 1,820 mg/day. He underwent a right trisectionectomy of the liver under a preoperative diagnosis of HCC. After the surgery, the patient's glucose intolerance completely improved and his serum aldosterone level returned to within the normal range. Pathological examination showed a moderately differentiated HCC, but an immunohistochemical study could not directly confirm any endocrine secretion. Although the cause or relationship of hyperaldosteronemia and diabetes was unclear, tumor compression of the right renal artery may have caused secondary hyperaldosteronism in this case. Consequently, resection of the tumor improved both of these abnormalities, this interesting case is reported here and discussed.

Key words
hepatocellular carcinoma, diabetes, hyperaldosteronism

Reprint requests
Junpei Yamaguchi Hepatobiliary and Pancreatic Surgery Division, National Cancer Center Hospital
5-1-1 Tukiji, Chuo-ku, Tokyo, 104-0045 JAPAN

Accepted
October 25, 2006

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