A case of well-differentiated hepatocellular carcinoma difficult to distinguish from hepatic angiomyolipoma

Abstract

A 73-year-old woman found to have a 5-cm mass in the S1 area of the liver by medical examination 18 years previously, and further investigation was recommended. However, she declined further tests. Recently, she had a checkup for epigastralgia, and underwent computed tomography (CT). CT showed a low density mass in the plain phase and a mildly enhanced mass in the hepatic arterial and portal phases. Abdominal magnetic resonance imaging scan suggested the existence of a fat component in the tumor. We suspected that the liver tumor was hepatocellular carcinoma or hepatic angiomyolipoma, and caudate lobe resection was performed. Histopathologically, the tumor was finally diagnosed as well differentiated hepatocellular carcinoma, though tumor histology was similar to liver cell adenoma. Clinically and histopathologically, well-differentiated hepatocellular carcinoma may be difficult to distinguish from liver cell adenoma.