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January 1988

Hepatocellular Carcinoma and the Watery Diarrhea Syndrome

Author Affiliations

First Department of Internal Medicine Perugia University Medical School Perugia 06100 Italy

Arch Surg. 1988;123(1):124. doi:10.1001/archsurg.1988.01400250134033

To the Editor.—We would like to briefly describe a case of hepatocellular carcinoma presenting with intractable diarrhea, similar to that reported in the July 1986 issue of the Archives.1

Our patient was hospitalized for pain in the right hypochondrial region that radiated to the back and a 15-day history of diarrhea. His stools were abundant, watery, and even occurred at night, but with no evident blood.

Blood analysis disclosed a raised sedimentation rate; an increased alkaline phosphatase level (615 U/L; normal value, <130 U/L); and slightly increased aspartate aminotransferase (115 U/L; normal value, <40 U/L), alanine aminotransferase (95 U/L; normal value, <40 U/L), and γ-glutamyl transferase (85 U/L; normal value, <50 U/L) levels.

Both ultrasonography and computed tomography revealed a 12-cm neoformation, with an irregular profile and dishomogeneous profile structure in the right lobe of the liver. Selective hepatic artery angiography revealed that the mass was highly vascularized.

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