Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2022; 10(28): 10130-10135
Published online Oct 6, 2022. doi: 10.12998/wjcc.v10.i28.10130
Multiple primary malignancies – hepatocellular carcinoma combined with splenic lymphoma: A case report
Fa-Zong Wu, Xiao-Xiao Chen, Wei-Yue Chen, Qiao-Hong Wu, Jian-Ting Mao, Zhong-Wei Zhao
Fa-Zong Wu, Xiao-Xiao Chen, Wei-Yue Chen, Qiao-Hong Wu, Jian-Ting Mao, Zhong-Wei Zhao, Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Hospital of Zhejiang University, Lishui 323000, Zhejiang Province, China
Author contributions: Wu FZ and Chen XX contributed equally to this work; Chen WY, Mao JT and Wu QH are responsible for case analysis; Chen XX analysed the data and wrote the manuscript; Zhao ZW checks and revises the manuscript; all authors have read and approve the final manuscript.
Supported by the Medical and Health Technology Plan of Zhejiang Province, No. 2020KY1086 and No. 2022ZH086.
Informed consent statement: Informed written consent was obtained from the patient regarding the publication of this report and accompanying images.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhong-Wei Zhao, MD, Chief Doctor, Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Hospital of Zhejiang University, No. 289 Kuocang Road, Liandu District, Lishui 323000, Zhejiang Province, China. zhaozw79@163.com
Received: February 24, 2022
Peer-review started: February 24, 2022
First decision: April 19, 2022
Revised: May 9, 2022
Accepted: August 21, 2022
Article in press: August 21, 2022
Published online: October 6, 2022
Processing time: 215 Days and 12.5 Hours
Abstract
BACKGROUND

Primary liver cancer is one of the most common malignant tumours, while primary splenic lymphoma is a rare malignancy. Thus, cases of hepatocellular carcinoma (HCC) combined with splenic lymphoma are extremely rare.

CASE SUMMARY

We present a 62-year-old woman who was admitted to the Interventional Radiology Department with a lump in the spleen and liver as well as multiple enlarged lymph nodes visible by ultrasound. Contrast-enhanced computed of the abdomen revealed a circular, low-density, shallow mass (approximately 2.6 cm in diameter) in the left intrahepatic lobe and multiple round, low-density shadows in the spleen with clear boundaries (maximum diameter 7.6 cm). Based on the characteristic clinical symptoms and explicit radiological findings, the clinical diagnosis was HCC with metastasis to the liver portal, retroperitoneal lymph nodes, and spleen. After transcatheter arterial chemoembolization and sequential radiofrequency ablation, the -fetoprotein level returned to the normal range, and the hepatitis B cirrhosis improved. In addition, splenic tumour biopsy confirmed the diagnosis of primary malignant lymphoma, which went into remission after chemotherapy.

CONCLUSION

HCC with primary splenic non-Hodgkin lymphoma is extremely rare and easily misdiagnosed. Better understanding would facilitate early diagnosis, treatment and prognosis.

Keywords: Multiple primary malignancies; Hepatocellular carcinoma; Splenomegaly; Extra-hepatic primary malignancy; Magnetic resonance imaging; Primary non-Hodgkin's lymphoma; Case report

Core Tip: This case of hepatocellular carcinoma with splenic primary non-Hodgkin lymphoma is extremely rare and easily misdiagnosed. A better understanding of such cases would facilitate early diagnosis, treatment and prognosis.