A Successfully Resected Case of Adult Hepatoblastoma with Hepatitis C

Toru Beppu, Ryuichi Karashima, Shinichi Sugiyama, Takatoshi Ishiko, Koichi Doi, Kazuharu Kai, Takahiko Satoh, Koei Ikeda*, Tetsu Kawaguchi** and Hideo Baba

Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University
Department of Surgical Pathology, Kumamoto University School of Medicine*
Department of Gastroenterology, Kumamoto Red Cross Hospital**

We reported a rare case of adult hepatoblastoma in a 54-year-old man with hepatitis C who was found to have a liver tumor in segment 6 during a medical checkup. AFP was elevated to 301 ng/m land the AFP-L3 ratio was 72.5%. Abdominal ultrasound showed a mixed-echo tumor. Abdominal CT showed a low-density area with unclear border. After administration of contrast medium, the tumor was partially enhanced in the early phase without washout in late phase. Systematic posterior segmentectomy was successful. The tumor was 3 cm in diameter and was the smallest adult hepatoblastoma known, to the best of our knowledge. HE staining showed a fibrous capsule and septum, with some foci of hemorrhage, necrosis, and fibrosis in the tumor. Embryonal epithelial cells with hyperchromatic nuclei had proliferated irregularly. Osteoid-like and cartilaginous foci, myxomatous stroma, and tumor cells multiplied in a trabecular pattern similar to hepatocellular carcinoma were observed. Pathological examination showed mixed epithelial and mesenchymal hepatoblastoma. The background liver was assessed as F3-F4 in staging of fibrosis and A2 in grading of inflammation. The patient was definitively diagnosed with Stage III based on staging criteria of primary liver cancer in Japan. Adjuvant hepatic arterial chemotherapy with cisplatin and farmorubicin was done, and the patient has been well and free of recurrence for about two years, with tumor markers remaining normal.

Key words
adult hepatoblastoma, C-type hepatitis, hepatic resection

Reprint requests
Toru Beppu Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University,
1-1-1 Honjo, Kumamoto, 860-8556 JAPAN

Accepted
June 22, 2005

To read the PDF file you will need Abobe Reader installed on your computer.