Erythrocytosis caused by an erythropoietin-producing hepatocellular carcinoma

A case of erythrocytosis caused by a hepatocellular carcinoma (HCC) that pr oduced erythropoietin (Epo) is described. A 64-year-old man, with a huge HC C tumor in the right lobe of the liver, showed a high concentration of hemo globin and increased levels of serum Epo, ol-fetoprotein (AFP), and protein induced by vitamin K absence II (PIVKA-II). Right lobectomy of the liver w as performed. Histological findings of the specimen showed a moderately dif ferentiated HCC. The existence of Epo was confirmed immunohistochemically o nly in the tumor tissue and not in the normal liver tissue. Erythrocytosis disappeared and the serum levels of Epo, AFP, and PIVKA-II returned to the normal range after the operation. Within 2 months after the operation, recu rrent tumors appeared in the remnant liver, and the patient died 13 months after the operation. J. Surg. Oncol. 2000;75:197-202. (C) 2000 Wiley-Liss, Inc.