Hepatocellular Carcinoma Associated with Long-term Cyclophosphamide Therapy for Wegener Granulomatosis

The development of hepatocellular carcinoma (HCC) requires persistent hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. The other origins are extremely rare. A 63-year-old woman was admitted to our hospital for work-up of hepatic mass. She took cyclophosphamide for Wegener granulomatosis for 21 years. Serum HBV and HCV markers were negative. A diagnosis of HCC was made by the imaging findings, and an extended left lobectomy of the liver was performed. Histologically, the tumor was diagnosed as moderately differentiated HCC. We thus considered the HCC in this case as a complication of the long-term cyclophosphamide by the absence of known causes of HCC.