The Impact of the Pandemic on the Progression and Delayed Diagnosis of Hepatocellular Carcinoma with Associated Infection: A Case Report
Victoria Lopes Cunha e Silva, MD, Guilherme Queiroz Looney, Carolina Marques, Nilcéia Aparecida Mota Marques, MD, MS
Abstract
Objective: To present a case of late diagnosis of hepatocellular carcinoma complicated by cutaneous focus infection due to uncontrolled diabetes mellitus. Additionally, to discuss treatment options, risk factors, relevant literature, and the impacts of the Covid-19 pandemic on diagnostic delays. Case report: A patient diagnosed with alcoholic liver disease since 2019 lost ambulatory follow-up due to the Covid-19 pandemic. However, in 2023, he presented with generalized 4+/4 jaundice, ascites, anorexia, unquantified weight loss, and night sweats more than twice a week, as well as constipation. He denied fever, bleeding, and vomiting. He was admitted to Hospital Universitário Getúlio Vargas and also required significant surgical intervention. Imaging exams revealed multiple nodular lesions in the liver, raising suspicion for hepatocellular carcinoma. After stabilizing the patient and establishing the diagnosis, he was referred to the Fundação Centro de Controle de Oncologia do Estado do Amazonas (FCECON) for abscess drainage and to the Hepatology outpatient clinic for further management. Discussion: The Covid-19 pandemic led to the suspension of many outpatient activities in order to avoid virus transmission, resulting in many patients losing follow-up for various comorbidities. The patient's disease progression in the subsequent years was intense both in laboratory and clinical aspects. Previous imaging exams from 2020 did not show any expansive lesions, whereas recent exams showed suggestive nodules and signs of fibrosis.
Full Text: PDF DOI: 10.15640/ijhs.v12n1a3
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