Unexplained Leg Swelling Leading to a Diagnosis of Hepatocellular Carcinoma: A Case Report

TL;DR

A 77-year-old woman with leg swelling was later diagnosed with liver cancer, showing that unexplained edema can be a rare sign of hepatocellular carcinoma.

Contribution

This case report highlights the rare presentation of hepatocellular carcinoma as unexplained peripheral edema.

Findings

Bilateral leg swelling led to the diagnosis of hepatocellular carcinoma after ruling out cardiac and renal causes.

Elevated alpha-fetoprotein and abdominal imaging confirmed the HCC diagnosis.

The case emphasizes the need for comprehensive evaluation in patients with unexplained edema.

Abstract

Hepatocellular carcinoma (HCC) typically presents with abdominal pain, jaundice, or hepatic decompensation. However, peripheral edema as an initial presentation is uncommon and may lead to diagnostic delays. Here, we report the case of a 77-year-old woman with underlying diabetes mellitus, hypertension, and dyslipidemia who presented with bilateral leg swelling. Cardiac and renal evaluations were unremarkable. Liver function tests revealed mild derangement. Further investigations, including abdominal imaging and elevated alpha-fetoprotein levels, confirmed the diagnosis of HCC. This case highlights the importance of considering hepatic malignancy in patients presenting with unexplained peripheral edema. A comprehensive clinical evaluation and timely imaging are crucial for early diagnosis and improved patient outcomes.

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