Abstract
An 83–year–old woman with hypertension and dyslipidemia seen for epigastralgia, nausea, and anorexia and who only rarely drank alcohol had mild anemia. Computed tomography (CT) indicated hepatic left–lobe tumor rupture and hemorrhage. Prior to transcatheter arterial embolization (TAE), laboratory data showed mild liver dysfunction but was negative for HBsAg and anti–HCV, antinuclear antibody. AFP tumor markers were abnormally elevated at 44,000. Following left lobectomy, the tumor was diagnosed histologically as well–differentiated hepatocellular carcinoma (HCC). Liver background showed steatosis, hepatocytic ballooning, and inflammatory–cell infiltration without advanced fibrosis, yielding a final diagnosis of HCC arising in noncirrhotic, nonalcoholic steatohepatitis (NASH). Few case reports of HCC in noncirrhotic NASH are known, but subjects with NASH, especially with complications, such as diabetes, hypertension, and dyslipidemia, should be carefully monitored.
