A Case of Fibrolamellar Hepatocellular Carcinoma

Takuya Nojiri, Norio Mitsumori, Tatsuya Yoshida, Toshihiko Shinohara, Jun Asakura, Naoki Doi, Isao Miyoshi, Yoji Yamazaki^* and Hiroshi Hano^**

Department of Surgery, Kanagawa Prefectual Atsugi Hospital Department of Surgery^* and Pathology^**, The Jikei University School of Medicine

A 27-year-old woman was treated for fibrolamellar hepatocellular carcinoma (FLC), which is very rare in Japan. The patient was admitted because of a huge liver tumor with no signs of liver cirrhosis. Virus antigen and antibody tests for hepatitis were negative. Although the serum AFP was within a normal range, the PIVKA-II was slightly elevated to 108 mAU/ml. US and plain CT examinations revealed a 10 cm mass in the right hepatic lobe. In the early phase of a contrast-enhanced CT, the tumor was well enhanced. In the delayed phase, the septums and capsule of the tumor were enhanced, but the central part of the tumor was not enhanced. An angiography revealed a tumor stain and invasion to the right portal vein. No signs of a tumor were seen in the alimentary tract. The patient was diagnosed with a primary hepatocellular carcinoma, and then extended right hepatectomy was performed. Post-operative histopathological examination confirmed the presence of FLC. According to previous reports, FLC developed solitarily in a young adult with no signs of liver cirrhosis. In those cases, the AFP level was not elevated, and the prognosis after resection was comparatively good.

Key words
fibrolamellar hepatocellular carcinoma, alpha-fetoprotein, non liver cirrhosis

Reprint requests
Takuya Nojiri Department of Surgery, The Jikei University School of Medicine 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo, 105-8461 JAPAN

Accepted
September 20, 2000

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