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Case Report

Hepatocellular carcinoma and type 2 diabetes mellitus: two

cases highlighting changes in tumor glycogen content

4
1
3
2
Kunio Takegoshi , Eikichi Okada , Kazuhiro Nomoto , Kouji Nobata ,
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Takuro Sawasaki , Mitsuhiro Terada , Hirofumi Terakawa , Takashi Kobayashi ,
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Kazuhisa Yabushita , Tatsuho Sugimoto , Shintaro Terahata 8
1 Takegoshi Internal Medicine Clinic, 377-7 Nomura, Takaoka, Toyama 933-0014, Japan
2 Pathological Division of Takaoka City Hospital, 4-1 Takara-machi, Takaoka, Toyama 933-8550, Japan
3 Pathological Division of Kouseiren Takaoka Hospital, 5-10 Eirakucho, Takaoka, Toyama 933-8555, Japan
4 Radiological Division of Kouseiren Takaoka Hospital, 5-10 Eirakucho, Takaoka, Toyama 933-8555, Japan
5 Gastroenterological Division of Kouseiren Takaoka Hospital, 5-10 Eirakucho, Takaoka, Toyama 933-8555, Japan
6 Surgical Division of Takaoka City Hospital, 4-1 Takara-machi, Takaoka, Toyama 933-8550, Japan
7 Gastroenterological Division of Kanazawa Seirei Hospital, 1 Chome-5-30 Nagamachi, Kanazawa, Ishikawa 920-0865, Japan
8 Pathological Division of Tonami General Hospital, 1-61 Shintomi-cho, Tonami, Toyama 939-1395, Japan
ABSTRACT
This article reports two patients with hepatocellular carcinoma (HCC) and type 2 diabetes mellitus (T2DM), who showed
marked changes in hepatocellular glycogen content. Periodic acid-Schiff (PAS)-positive and diastase-PAS-negative
(glycogen-storing) hepatocytes were detected in both background liver parenchyma and in HCC tissues. In HCC tissues, the
number of glycogen-storing cells resembling hepatocytes was considerably reduced and unevenly distributed as compared
with hepatocytes in background liver. To be known, changes in hepatocellular glycogen content in T2DM patients have not
been previously described. It is hypothesized that the reduction in glycogen content in both patients was likely associated with
the emergence of Warburg type of glycolysis.

Key words: Glycogen; hepatocellular carcinoma; hexokinase II; steatohepatitis; type 2 diabetes mellitus

Address for correspondence:
Dr. Kunio Takegoshi, Takegoshi Internal Medicine Clinic, 377-7 Nomura, Takaoka, Toyama 933-0014, Japan. E-mail: kunio@takegoshi.jp
Received: 10-04-2015, Accepted: 06-09-2015

INTRODUCTION associated with HCC. Patients with T2DM and NAFLD-
[4]
related non-cirrhotic or cirrhotic livers may develop HCC,
Most cases of hepatocellular carcinoma (HCC) occur in suggesting a role for T2DM in hepatocarcinogenesis. [3]
patients with chronic liver disease and advanced fibrosis.
Well-known causes of chronic liver disease leading to Glycogen loading of the liver was first documented
HCC include chronic hepatitis B virus (HBV) and hepatitis as a component of Mauriac’s syndrome in 1930, and
[1,2]
[1]
C virus infection, chronic alcohol abuse and more
recently, non-alcoholic fatty liver disease (NAFLD). In This is an open access article distributed under the terms of the Creative
[3]
addition, type 2 diabetes mellitus (T2DM) has been Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows
others to remix, tweak, and build upon the work non-commercially, as long as the
author is credited and the new creations are licensed under the identical terms.
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How to cite this article: Takegoshi K, Okada E, Nomoto K, Nobata
K, Sawasaki T, Terada M, Terakawa H, Kobayashi T, Yabushita K,
DOI: Sugimoto T, Terahata S. Hepatocellular carcinoma and type 2 diabetes
10.4103/2394-5079.168725 mellitus: two cases highlighting changes in tumor glycogen content.
Hepatoma Res 2016;2:26-30.

26 © 2016 Hepatoma Research | Published by OAE Publishing Inc.