hypericum and Carcinoma--Hepatocellular

Topics: Antineoplastic Agents, Phytogenic; Apoptosis; Carcinoma, Hepatocellular; Cell Cycle Checkpoints; Cell Line, Tumor; Cell Proliferation; Crystallography, X-Ray; Density Functional Theory; Dose-Response Relationship, Drug; Drug Discovery; Drug Screening Assays, Antitumor; Humans; Hypericum; Models, Molecular; Molecular Structure; Phloroglucinol; Structure-Activity Relationship

Hepatocellular carcinoma (HCC) often develops in patients with underlying liver disease, yet HCC with syncytial giant cells (SGCs) is extremely rare. Herein, we report a 55-year-old man with a 6-year history of alcoholic cirrhosis who during his regular checkup presented with marked elevation of alpha-fetoprotein. Clinical examination and imaging analyses revealed a tumor-like lesion in segment 4 of the liver, which was removed by limited wedge resection. Histological analysis by hematoxylin and eosin staining indicated pleomorphic and atypical nodules, with some SGCs, embedded within the boundaries of the neoplastic lesion. The adjacent liver parenchyma showed microvesicular steatosis, pericellular fibrosis, and moderate hemosiderin accumulation (grade 2, as determined by Prussian blue iron stain) in hepatocytes and Kupffer cells but no copper accumulation (as determined by orcein stain). Immunohistochemical analysis showed hepatocyte antigen-positive staining for the neoplastic cells and SGCs. The diagnosis was made for cirrhosis-related HCC with SGCs. The previous reports of pleomorphic HCC have featured osteoclast-like (i.e., mesenchymal type) giant cells, making this case of epithelial type giant cells very rare. The patient's 6-month history of hypericum perforatum/St John's wort self-medication may have prompted the cirrhosis or HCC progression or the unusual SGC manifestation.

Topics: alpha-Fetoproteins; Carcinoma, Hepatocellular; Disease Progression; Hepatocytes; Humans; Hypericum; Immunohistochemistry; Liver; Liver Cirrhosis, Alcoholic; Liver Neoplasms; Magnetic Resonance Imaging; Male; Middle Aged; Osteoclasts; Phytotherapy; Plant Extracts

Ten different samples of five Hypericum sp. were tested on brine shrimps, human colon carcinoma and human hepatoma cell lines for their cytotoxic activities. H. triquetrifolium Turra. (Rafina) showed the highest activity (LC50 = 22 mg/mL) on brine shrimps, while the extracts of the other nine samples showed significant to moderate activities (LC50 from 37 to 107 mg/mL). H. empetrifolium Wild. (Parnon) showed the highest activity in human colon carcinoma and human hepatoma cell lines, with LC50 values 29 and 25.1 mg/mL, respectively, while the LC50 values of the other samples were more than 45 mg/mL. It is very interesting to observe that most Hypericum samples showed good antioxidant activity in vitro.

Topics: Animals; Antioxidants; Artemia; Caco-2 Cells; Carcinoma, Hepatocellular; Colonic Neoplasms; Humans; Hypericum; Lethal Dose 50; Phytotherapy; Plant Extracts; Tumor Cells, Cultured