RESUMO
Multiple primary malignant tumors are characterized by independent occurrence and development of two or more malignant neoplasms in the same patient. We present an extremely rare case of synchronous double primary malignancies, hairy cell leukemia and hepatocellular carcinoma with lethal outcome. Diagnosis of hepatocellular carcinoma was difficult due to the presence of lymphoproliferative disease, which complicated the visualization of the process using ultrasonography. Carcinomatous emboli of hepatocellular carcinoma in small pulmonary arteries without the formation of metastatic foci have led to clinical manifestations typical of pulmonary embolism, pulmonary hypertension and severe respiratory failure. In lymphoproliferative diseases it is necessary to take into account the possibility of the development of another malignant neoplasm, which can be "buried" by tumor infiltration.
Assuntos
Carcinoma Hepatocelular , Leucemia de Células Pilosas , Neoplasias Hepáticas , Neoplasias Primárias Múltiplas , Humanos , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/diagnóstico por imagem , Neoplasias Hepáticas/diagnóstico por imagem , Leucemia de Células Pilosas/complicações , Leucemia de Células Pilosas/diagnóstico , Leucemia de Células Pilosas/patologia , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias Primárias Múltiplas/patologiaRESUMO
The clinical case of refractory hepatoblastoma with lethal outcome followed by pathomorphological verification has been analyzed. The true causes of hepatoblastoma development remain unknown. The prognostic factors of the disease require detailed study in complex investigations that would include histological, clinical, laboratory, and immunohistochemical characteristics. However, comparing clinical and histopathological parameters with CD10 expression could have a diagnostic role and may be useful in understanding tumorigenesis and prognostic analysis of a given tumor.