Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019204 (hepatocellular carcinoma)
 71,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Described is a 57-year-old male with a complaint of a gait disturbance. On admission to hospital, he was suffering from almost complete paraplegia. Roentgenograms of the spine showed extensive destruction in the body of the second thoracic vertebra. Magnetic resonance computed tomography revealed a vertebral tumor that was compressing the vertebral cord. Thus, a laminectomy of the 1st to 3rd thoracic vertebra was performed to relieve the compression. Histological examination of the tumor showed it to be a metastatic vertebral tumor from a hepatocellular carcinoma (HCC). Subsequently, by abdominal computed tomography and an examination of the AFP serum level the existence of the HCC was confirmed. This is a very rare case of an HCC that was revealed by paraplegia caused by bone metastasis.
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PMID:[A hepatocellular carcinoma revealed by paraplegia caused by a vertebral metastasis]. 255 10

A 73-year-old woman (height : 155 cm, weight : 55 kg) was scheduled to undergo a laparotomic hepatectomy and radiofrequency ablation for hepatocellular carcinoma. Her medical history did not include any relevant conditions such as cardiovascular or neurological disorders. A thoracic epidural catheter was introduced at T8-9 before the induction of anesthesia with intravenous propofol. General anesthesia was maintained with the inhalation of oxygen, air, and desflurane, and the continuous infusion of remifentanil. Several intraoperative episodes of mild hypotension occurred, each of which was successfully treated with intravenous ephedrine, but otherwise her anesthetic course was uneventful, and she recovered from the anesthesia smoothly. Her postoperative pain was well controlled with continuous epidural infusion of levobupivacaine and fentanyl, and she could walk by herself on postoperative day (POD) 1. However, she suffered weakness in her lower extremities on POD2 and subsequently fell into complete paraplegia with sensory loss below the T4 level on POD3. A magnetic resonance imaging scan taken on POD4 showed an idiopathic spinal cord infarction (SCI) involving levels T1 through T4, although no epidural abnormalities, e.g., hematomas, were detected. Immediate treatment with methylprednisolone, ozagrel, and edaravone failed to resolve her symptoms. We suggest that it is of great importance to consider SCI as a differential diagnosis as soon as possible in cases of unanticipated postoperative paraplegia.
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PMID:[A Case of Postoperative Paraplegia Caused by Idiopathic Spinal Cord Infarction following Hepatectomy under Both General and Epidural Anesthesia]. 2641 3