A case of hepatocellular carcinoma consisted with heterogenous nodules with and without production of AFP.

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A 59-year-old male who had been treated for liver cirrhosis was admitted to our hospital because of elevation of AFP and abnormality of echogram. Ultrasonography performed on admission demonstrated a hypoechoic mass adjacent to a hyperechoic nodule. Angiography showed two hypervascular nodules such as a snowman, but each vascularity was the same. Because of his refusal of operation, intraarterial infusion of carcinostatics was performed twice, and then serum level of AFP fell from 252 to 80ng/ml and continued to show lower level than 200ng/ml. But AFP increased to 1200ng/ml 19 months later, and angiography revealed that tumor grew larger to the size of 4.5 × 2.7cm. Because residual liver function was preserved, hepatectomy was performed. Ultrasonogram of resected specimen also showed hyperechoic tumor adjacent to the hypoechoic mass. Histological examination revealed that the former was of grandular type of hepatocellular carcinoma with production of AFP and the latter was of compact type (Edmondson IV type) without the production of AFP.
社団法人日本肝臓学会の論文