# A Case Report of a Rapid Development of Hepatocellular Carcinoma (HCC) Within Six Months of Hepatitis C Cure in an Individual With Risk Factors

## TL;DR

A 63-year-old man with a history of liver disease and cured hepatitis C developed hepatocellular carcinoma (HCC) within six months of treatment, highlighting the risk of HCC even after successful hepatitis C resolution.

## Contribution

This case report highlights the rapid onset of HCC following hepatitis C cure in a patient with multiple liver risk factors.

## Key findings

- A 2.4 cm poorly differentiated HCC was detected in the right hepatic lobe six months after hepatitis C cure.
- The patient had multiple risk factors including cirrhosis, alcohol use, and end-stage renal disease.
- HCC can develop rapidly even in the absence of classic symptoms like jaundice or weight loss.

## Abstract

People with chronic liver disease are more likely to develop hepatocellular carcinoma (HCC), especially those with cirrhosis or fibrosis. Confounding variables, such as alcohol consumption, end-stage renal disease, and poorly controlled diabetes mellitus, can lead to detrimental outcomes such as the development of HCC since the liver is already damaged and in a recovery phase from the resolved hepatitis C infection. HCC should be a high differential diagnosis even in the absence of classical signs and symptoms of jaundice or weight loss given the resolved hepatitis C infection. In this case study, a 63-year-old male with a past medical history of intravenous (IV) drug use, chronic alcoholic cirrhosis, end-stage renal disease, and cured hepatitis C infection presented at the primary care office for a regular follow-up visit after getting discharged from the emergency department (ED). During a routine primary care visit, the patient complained of right upper quadrant pain, constipation, and intermittent dizziness. At the time, he also endorsed drinking a case of beer daily and a fifth of liquor monthly. He had a history of hepatitis C, which he acquired through IV drug use. He was successfully treated with a six-month course of glecaprevir/pibrentasvir with eradication of the virus. Before the primary care practitioner (PCP) visit, the patient had an ED visit for abdominal pain and chronic constipation, during which he underwent a non-contrast CT of the abdomen, with an incidental finding of a 2.4 cm liver mass in the right hepatic lobe. It was followed up with an MRI and CT-guided biopsy, the results of which showed poorly differentiated HCC.