A Case of Hepatocellular Carcinoma with Sarcomatous Change that Occurred in a Patient with Chronic Hepatitis C which was difficult to Distinguish from Liver Abscess

Yuji Masaki, Takashi Ueno, Hirotaka Hamada and Takashi Akiyama*

Department of Surgery, Okamura Isshindou Hospital
Department of Pathology, Kawasaki Medical University Hospital*

We report a very rare case of hepatocellular carcinoma with sarcomatous change occurring as a liver abscess. A 68-year-old male who was diagnosed with a liver abscess in ultrasonography and seen for high fever and right chest pain. Abdominal computed tomography (CT) revealed a solitary liver tumor 6 cm in diameter with ring enhancement at the posterior lobe. For the liver abscess, we conducted percutaneous drainage and recognized a little grayish pus. We decided to operate when the inflammatory reaction lasted more than 10 days. Pathohistological examination showed diffuse tumor cell growth with mitosis and necrosis. In immunohistochemical staining, tumor cells were strongly positive for vimentin and MIB-1, and were arranged trabecularly in silver staining. Hepatocellular carcinoma with sarcomatous change grows invasively, features a high incidence of extrahepatic metastasis, and follows a rapid clinical course.

Key words
hepatocellular carcinoma, sarcomatous change, liver abscess

Reprint requests
Yuji Masaki Department of Surgery, Okamura Isshindou Hospital
2-1-7 Saidaiji-Minami, Okayama, 704-8117 JAPAN

Accepted
January 31, 2007

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