Direct measurement of the red cell mass has confirmed a previous report of the occurrence of polycythemia in patients with hepatocellular carcinoma. Twenty patients (17 males and 3 females) have been investigated. The red cell mass was increased in 11, normal in 8 and reduced in one. Because of hypervolemia, present in 15 of the 20 patients investigated and attributable to the associated cirrhosis of the liver, the hematocrit might be normal in the presence of an increased red cell mass. A venous hematocrit of 48 per cent and above was found invariably to be associated with an increase in the red cell mass. Using this criterion, 17 of 145 patients with hepatocellular carcinoma were found to be polycythemic, an incidence of 11.7 per cent.
Plasma erythropoietic stimulating factor determined by Fe59 incorporation into red cells of fasted rats was not increased in 4 patients with hepatocarcinoma and polycythemia.
These findings are briefly discussed.