Microhamartomaに合併した肝細胞癌の1切除例.

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A 57-year-old man who had been found to have high serum levels of α-fetoprotein at different times was admitted to our hospital. He was diagnosed as having hepatocellular carcinoma in the right anterior segment of the liver by computed tomography and ultrasonography. Blood tests showed that cirrhosis of the liver was not present, and portal vein pressure, mesured during percutaneous transhepatic portography (PTP), was within the normal limits. We thought the patient also had severe liver fibrosis because of the hard consistency of the liver at PTP. Transcatheter arterial embolization (TAE) was followed by percutaneous transhepatic portal embolization (PTPE), after an interval of two weeks, and right anterior segmentectomy was done later. In the specimen, the tumor was found to be a solitary nodule with intrahepatic metastatic lesions and portal emboli. The tumor had the trabecular pattern of hepatocellular carcinoma histologically, and was classified as Edmondson's type II. Another area of the liver had microhamartoma; there were small yellowish multiple nodules of fibrous tissue in which there were many irregularly dilated bile-duct-like structures. Bile duct carcinoma with biliary anomalies are occasionally reported. This is the first case of hepatocellular carcinoma with microhamartoma to be reported, to the best of our knowledge.
社団法人日本肝臓学会の論文