Hepatocellular carcinoma having progressive dyspnea as clinical presentation.

Hepatocellular carcinoma (HCC) can give multiple different initial clinical presentations. To the author's knowledge, however, dyspnea has not yet been recorded as an initial clinical presentation of HCC. A 39-year-old woman who had dyspnea for 2 months because of HCC is, therefore, reported herein. A chest X-ray revealed reticulonodular infiltration of lungs which led to antituberculous treatment. She died 3 months after initial dyspnea. An autopsy demonstrated a HCC, 1.5 x 2 x 2 cm, at the edge of the left lobe of the liver with widespread intravascular metastases to the lungs. The patient, moreover, had hypertrophy of the right cardiac ventricle being compatible with cor pulmonale. These pulmonary and cardiac findings are regarded to have produced dyspnea in this case.