A Curative Resective Case of Giant Fibrolamellar Hepatocellular Carcinoma with Lymphnode Metastasis

Yoshio Ooeda, Toshio Isono, Shigeru Yoshioka, Kazuo Wakatsuki, Yuzi Nukui, Hitoshi Takahashi, Seiya Nabeshima, Takeo Nishino*, Toshimi Takahashi* and Masaru Miyazaki**

Department of Surgery and Department of Pathology*, Chiba Municipal Hospital
Department of General Surgery, Chiba University Graduate School of Medicine**

Fibrolamellar hepatocellular carcinoma (FLC) is a specific type hepatocellular carcinoma characterized by specific pathological findings , and is extremely rare in Japan. We report a case of a 23-year-old male Japanese patient with a huge FLC with lymphnode metastasis who remains alive without cancer recurrence in the over 14 years since surgery. During ultrasonography a tumor was seen in the liver of the patient, who was negative for the hepatitis virus (HBV and HCV). Computed tomography (CT) of the abdomen showed a 16 cm in diameter tumor in the right lobe of the liver. Dynamic CT and celiac angiography revealed a hypervascular tumor which had a non-enhancing lesion at the center. These findings suggested a central scar. Tc-99m phytate scintigraphy showed a large defect in the tumor. Under the preoperative diagnosis of an FLC, a right lobectomy of the liver, hepatic hilar lymphadenectomy, and hepatic arterial cannulation were perfomed. Histological examination demonstrated polygonal eosinophilic cells separated by lamellar collagen.

Key words
fibrolamellar hepatocellular carcinoma, lymphnode metastasis, focal nodular hyperplasia

Reprint requests
Yoshio Ooeda Department of Surgery, Chiba Municipal Hospital
3-31-1 Isobe, Mihama-ku, Chiba, 261-0012 JAPAN

Accepted
April 27, 2005

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