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

• Published in: Nippon Shokaki Geka Gakkai zasshi Vol. 38; no. 11; pp. 1732 - 1737
• Main Authors: Takahashi, Toshimi, Yoshioka, Shigeru, Wakatsuki, Kazuo, Nishino, Takeo, Miyazaki, Masaru, Isono, Toshio, Takahashi, Hitoshi, Nabeshima, Seiya, Ooeda, Yoshio, Nukui, Yuzi
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Gastroenterological Surgery 2005
• Subjects: fibrolamellar hepatocellular carcinoma; focal nodular hyperplasia; lymphnode metastasis
• ISSN: 0386-9768; 1348-9372
• DOI: 10.5833/jjgs.38.1732

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 nega-tive for the hepatitis virus (HBV and HCV). Computed tomography (CT) of the abdomen showed a 16cm 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 phy-tate 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. Histo-logical examination demonstrated polygonal eosinophilic cells separated by lamellar collagen.