Recurrent Hepatocellular Carcinoma in Patient with Crohn’s Disease: Incidental or Expected Outcome of Azathioprine?

Hepatocellular carcinoma (HCC) usually occurs in patients with underlying risk factors such as liver cirrhosis and chronic hepatitis B. Although patients with Crohn’s disease (CD) are at an increased risk to develop malignancies such as colon cancer, the incidence of HCC in this population is extrem...

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Main Authors: Youssef Botros, Mary Mathews, Hiren Patel, Nihar Shah, Walid Baddoura, Andrew de la Torre
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Gastrointestinal Medicine
Online Access:http://dx.doi.org/10.1155/2015/939136
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author Youssef Botros
Mary Mathews
Hiren Patel
Nihar Shah
Walid Baddoura
Andrew de la Torre
author_facet Youssef Botros
Mary Mathews
Hiren Patel
Nihar Shah
Walid Baddoura
Andrew de la Torre
author_sort Youssef Botros
collection DOAJ
description Hepatocellular carcinoma (HCC) usually occurs in patients with underlying risk factors such as liver cirrhosis and chronic hepatitis B. Although patients with Crohn’s disease (CD) are at an increased risk to develop malignancies such as colon cancer, the incidence of HCC in this population is extremely rare. We report a case of 62-year-old male with long history of CD treated with azathioprine (AZA) and aminosalicylic acid (ASA) who was incidentally diagnosed with HCC, for which left hepatectomy was done. Four years later during routine follow-up, patient had another hepatic lesion and underwent resection of the mass. The mechanism of occurrence of HCC in patient with CD is still controversial and may include immune mediated changes and medication related complications. AZA was reported in all case reports of CD that developed HCC. Through this report we hope to explore the complex pathophysiological mechanisms contributing to the development of HCC in the Crohn’s disease patient population.
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spelling doaj-art-adca2bca9ce64e6d82e37689355375ac2025-08-20T03:39:41ZengWileyCase Reports in Gastrointestinal Medicine2090-65282090-65362015-01-01201510.1155/2015/939136939136Recurrent Hepatocellular Carcinoma in Patient with Crohn’s Disease: Incidental or Expected Outcome of Azathioprine?Youssef Botros0Mary Mathews1Hiren Patel2Nihar Shah3Walid Baddoura4Andrew de la Torre5Department of Internal Medicine, St. Joseph’s Regional Medical Center, New York Medical College, Paterson, NJ 07503, USADepartment of Internal Medicine, St. Joseph’s Regional Medical Center, New York Medical College, Paterson, NJ 07503, USADepartment of Gastroenterology, St. Joseph’s Regional Medical Center, New York Medical College, Paterson, NJ 07503, USADepartment of Gastroenterology, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25755, USADepartment of Gastroenterology, St. Joseph’s Regional Medical Center, New York Medical College, Paterson, NJ 07503, USADepartment of General and Hepatobiliary Surgery, St. Joseph’s Regional Medical Center, Paterson, NJ 07503, USAHepatocellular carcinoma (HCC) usually occurs in patients with underlying risk factors such as liver cirrhosis and chronic hepatitis B. Although patients with Crohn’s disease (CD) are at an increased risk to develop malignancies such as colon cancer, the incidence of HCC in this population is extremely rare. We report a case of 62-year-old male with long history of CD treated with azathioprine (AZA) and aminosalicylic acid (ASA) who was incidentally diagnosed with HCC, for which left hepatectomy was done. Four years later during routine follow-up, patient had another hepatic lesion and underwent resection of the mass. The mechanism of occurrence of HCC in patient with CD is still controversial and may include immune mediated changes and medication related complications. AZA was reported in all case reports of CD that developed HCC. Through this report we hope to explore the complex pathophysiological mechanisms contributing to the development of HCC in the Crohn’s disease patient population.http://dx.doi.org/10.1155/2015/939136
spellingShingle Youssef Botros
Mary Mathews
Hiren Patel
Nihar Shah
Walid Baddoura
Andrew de la Torre
Recurrent Hepatocellular Carcinoma in Patient with Crohn’s Disease: Incidental or Expected Outcome of Azathioprine?
Case Reports in Gastrointestinal Medicine
title Recurrent Hepatocellular Carcinoma in Patient with Crohn’s Disease: Incidental or Expected Outcome of Azathioprine?
title_full Recurrent Hepatocellular Carcinoma in Patient with Crohn’s Disease: Incidental or Expected Outcome of Azathioprine?
title_fullStr Recurrent Hepatocellular Carcinoma in Patient with Crohn’s Disease: Incidental or Expected Outcome of Azathioprine?
title_full_unstemmed Recurrent Hepatocellular Carcinoma in Patient with Crohn’s Disease: Incidental or Expected Outcome of Azathioprine?
title_short Recurrent Hepatocellular Carcinoma in Patient with Crohn’s Disease: Incidental or Expected Outcome of Azathioprine?
title_sort recurrent hepatocellular carcinoma in patient with crohn s disease incidental or expected outcome of azathioprine
url http://dx.doi.org/10.1155/2015/939136
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