Abstract
A 25-year-old woman visited a local physician with acute enterocolitis, and ultrasound examination revealed a hepatic tumor. She had no past history of blood transfusions, oral contraceptive use, or steroid use. She had a history of ovarian cystectomy at the age of 11 years, and she had given birth to her first child one year earlier. Biochemical tests were negative for hepatitis virus markers, and no liver function abnormalities were seen. Although alpha-fetoprotein (AFP) was within the normal range, the protein induced by vitamin K absence or antagonist-II (PIVKA-II) was elevated (329 mAU/ml). Computed tomography (CT) showed a tumor having a diameter of 3.2 cm, with contrast enhancement in the lateral segment of the liver. On ultrasound examination, the tumor interior was hyperechoic, and the margin was hypoechoic. On liver biopsy, well-differentiated hepatocellular carcinoma was suspected. The patient underwent partial hepatectomy and had an uneventful postoperative course. Histopathological tests showed no fibrosis in the background liver. Cellular atypia at the tumor site was mild, however, increased cell density, capillarization of sinusoidal endothelial cells (CD34-positive), and interstitial infiltration were observed. The patient was diagnosed with well-differentiated hepatocellular carcinoma rather than hepatic adenoma.
