A Case of Scirrhous Hepatocellular Carcinoma with Various Histological Findings in Normal Liver

Sadanobu Izumi, Ryuichirou Ohashi, Yuji Onoda, Ichio Suzuka and Kunihiko Shiota

Department of Surgery, Kagawa Prefectural Central Hospital

A liver tumor was found in a 69-year-old man after detailed examinations had been performed because of liver dysfunction. Blood chemistry findings showed slight anemia and an elevation in transaminase and biliary enzyme values. A test for hepatitis virus was negative, and the patient's AFP and PIVKA-II values were extremely high. Abdominal dynamic computed tomography showed an enhanced mass located in segment 5/4 of the liver; the mass was about 9 cm in diameter and had a central scar. The preoperative diagnosis was hepatocellular carcinoma (HCC), and an S4+5 segmentectomy was performed. Microscopic findings showed remarkable fibrosis and various histological findings, but the tumor cells resembled non-scirrhous HCC, so a diagnosis of scirrhous HCC was made. Most scirrhous HCC lesions, which account for only a few percent of all HCC, occur in patients with virus hepatitis and present as moderately differentiated carcinoma, but many unidentified points, such as the characteristics and prognosis of this lesion, remain. We experienced a rare scirrhous HCC that ocurred in a normal liver; here, we report the pathognomonic images and pathological findings of this case and review the relevant medical literature.

Key words
scirrhous HCC, normal liver, without virus hepatitis

Reprint requests
Sadanobu Izumi Department of Surgery, Kagawa Prefectural Central Hospital
5-4-16 Bancho, Takamatsu, 760-8557 JAPAN

Accepted
January 25, 2006

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