Diffuse fatty metamorphosis of a large, well-differentiated hepatocellular carcinoma originating in the normal liver: a case report and literature review

Fatty changes are frequently observed in small, well-differentiated hepatocellular carcinomas (HCCs), but are rarely observed in large (over 30 mm in diameter) lesions. Here, we report a 76-year-old man who developed a large (58 mm in diameter), well-differentiated HCC with diffuse extensive fatty c...

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Bibliographic Details
Published in:Clinical journal of gastroenterology 2015-10, Vol.8 (5), p.345-350
Main Authors: Komiyama, Satoshi, Okazaki, Hiroshi, Nakao, Satoshi, Nishigori, Shuhei, Terada, Masahiro, Hamanaka, Jun, Miura, Yuki, Oka, Hiroyuki, Suzaki, Fumio, Tanaka, Katsuaki
Format: Article
Language:English
Subjects:
Abdominal Surgery
Aged
Carcinoma, Hepatocellular - pathology
Carcinoma, Hepatocellular - surgery
Case Report
Colorectal Surgery
Fatty Liver - pathology
Gastroenterology
Hepatology
Humans
Liver - pathology
Liver Neoplasms - pathology
Liver Neoplasms - surgery
Male
Medicine
Medicine & Public Health
Surgical Oncology
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Summary:Fatty changes are frequently observed in small, well-differentiated hepatocellular carcinomas (HCCs), but are rarely observed in large (over 30 mm in diameter) lesions. Here, we report a 76-year-old man who developed a large (58 mm in diameter), well-differentiated HCC with diffuse extensive fatty changes in the right lobe of the liver. He had no history of alcohol abuse, obesity, or hepatitis B or C infection, and no autoantibodies, but he did have type 2 diabetes. The serum alpha-fetoprotein level was within the normal range, and ultrasonography showed a round hyperechoic lesion. Dynamic contrast-enhanced computed tomography revealed a tumor with inhomogeneous low attenuation in the arterial, portal, and venous phases, mimicking an angiomyolipoma. The patient underwent central bisegmentectomy of the liver, and the histological diagnosis was well-differentiated HCC with diffuse extensive fatty changes. The surrounding non-cancerous area was normal. A review of the published literature found six published cases of large, well-differentiated HCC with extensive fatty changes. Unlike the patients in most previous reports, our patient did not have any underlying liver disease and had no history of alcohol abuse.
ISSN:1865-7257
1865-7265
DOI:10.1007/s12328-015-0606-7