Hepatic encephalopathy and orotic aciduria associated with hepatocellular carcinoma in a noncirrhotic liver

Lennox J Jeffers, R. A. Dubow, L. Zieve, K. J. Reddy, Alan Livingstone, S. Neimark, M. Viamonte, Eugene R Schiff

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Abstract

A 40-yr-old man presented with encephalopathy and was found to have hepatocellular carcinoma without cirrhosis. A large vascular hepatic mass was defined by CT scan and angiography; laparoscopy with biopsy confirmed the absence of chronic liver disease. A definitive tissue diagnosis of hepatocellular carcinoma was made at laparotomy; the tumor was unresectable. Peripheral arterial and selective portal and hepatic venous ammonia levels were high, and this finding suggested that the encephalopathy was nitrogenous and hepatic in origin. The proposed mechanisms of the encephalopathy are generation of ammonia from tumor breakdown and portosystemic shunting, a result of partial tumor occlusion of the hepatic veins. An unusually high urinary excretion of orotic acid was found similar to that seen in hereditary orotic aciduria.

Original languageEnglish
Pages (from-to)78-81
Number of pages4
JournalHepatology
Volume8
Issue number1
StatePublished - Jan 1 1988

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Hepatic Encephalopathy
Brain Diseases
Hepatocellular Carcinoma
Ammonia
Liver
Orotic Acid
Neoplasms
Hepatic Veins
Laparoscopy
Laparotomy
Blood Vessels
Liver Diseases
Fibrosis
Chronic Disease
Biopsy

ASJC Scopus subject areas

  • Hepatology

Cite this

Hepatic encephalopathy and orotic aciduria associated with hepatocellular carcinoma in a noncirrhotic liver. / Jeffers, Lennox J; Dubow, R. A.; Zieve, L.; Reddy, K. J.; Livingstone, Alan; Neimark, S.; Viamonte, M.; Schiff, Eugene R.

In: Hepatology, Vol. 8, No. 1, 01.01.1988, p. 78-81.

Research output: Contribution to journalArticle

Jeffers, LJ, Dubow, RA, Zieve, L, Reddy, KJ, Livingstone, A, Neimark, S, Viamonte, M & Schiff, ER 1988, 'Hepatic encephalopathy and orotic aciduria associated with hepatocellular carcinoma in a noncirrhotic liver', Hepatology, vol. 8, no. 1, pp. 78-81.
Jeffers, Lennox J ; Dubow, R. A. ; Zieve, L. ; Reddy, K. J. ; Livingstone, Alan ; Neimark, S. ; Viamonte, M. ; Schiff, Eugene R. / Hepatic encephalopathy and orotic aciduria associated with hepatocellular carcinoma in a noncirrhotic liver. In: Hepatology. 1988 ; Vol. 8, No. 1. pp. 78-81.
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