Published online Oct 6, 2022. doi: 10.12998/wjcc.v10.i28.10130
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
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.
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.
HCC with primary splenic non-Hodgkin lymphoma is extremely rare and easily misdiagnosed. Better understanding would facilitate early diagnosis, treatment and prognosis.
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.