Polycythemia in Primary Carcinoma of the Liver

In a series of 176 consecutive patients with hepatocarcinoma an increase in red cell count and in hemoglobin significantly above normal levels were encountered in 17 (10 per cent).

An investigation of 28 patients with hepatocarcinoma developing in a cirrhotic liver is reported. In three of the patients (10 per cent), the red cell counts and hemoglobin levels were significantly above those encountered in healthy Chinese.

In these 28 patients it has been shown that the plasma volume is increased, and this increase does not differ significantly from that encountered in uncomplicated cirrhosis of the liver. The total red cell volume, on the other hand, is significantly greater than in uncomplicated cirrhosis of the liver. While the mean total red cell volume in hepatocarcinoma is not significantly different from that in healthy controls, consideration of this finding in individual patients shows that it was above normal in 17, normal in six, and in the remaining five it was below normal.

It is concluded that the polycythemia encountered is a true polycythemia secondary to the development of the hepatocarcinoma. The expanded plasma volume is considered probably attributable to the pre-existing cirrhosis of the liver. Unfortunately, in the course of this investigation we did not encounter a patient in whom the carcinoma had developed in a liver which was not cirrhotic.