Coffee consumption as trigger for insulin dependent diabetes mellitus in childhood.

Comment Hepatocellular carcinoma is a frequent complication of liver cirrhosis, and patients usually die from gastrointestinal bleeding, cachexia, or liver failure. The clinical healing of our patient's hepatocellular carcinoma may have been related to the severe haemorrhagic shock. Because of its high metabolic requirements neoplastic tissue is more sensitive than normal tissue to a sudden reduction of the blood and oxygen supply. The liver receives a dual blood supply from the hepatic artery and the portal vein, whereas hepatomas are fed predominantly by the hepatic artery.2 Surgical procedures such as transcatheter arterial chemoembolisation3 and ligation of the hepatic artery branch4 have therefore been proposed to induce anoxia of the tumour when hepatectomy cannot be performed. The haemorrhage probably produced optimal conditions to kill neoplastic cells without damaging normal tissues. The sensitivity of hepatocellular carcinoma to a reduction in blood supply would therefore seem to be confirmed by this case history.