Abstract
A 67-year-old female patient presented with a hepatic tumor in the lateral segment of the liver with an extrahepatic tumor in the left upper quadrant of the abdomen, as detected on screening ultrasonography. Her serum alpha-fetoprotein (AFP) level was elevated to 16,500 ng/ml. The diagnosis was hepatocellular carcinoma with extra hepatic growth, and a left lateral sectionectomy with resection to the extrahepatic tumor and spleen and a left lung partial resection were performed. Regarding pathological findings, the majority of the intrahepatic tumors were cholangiocellular carcinoma with Hering tube-like structures. Immunohistochemical staining revealed that the tumor cells were cytokeratin 19-positive. Some AFP-positive cells were also observed. Pathological examination of the extrahepatic tumor showed moderately differentiated hepatocellular carcinoma with AFP- and cytokeratin 19-positive cells. Six months after the surgery, a recurrent tumor was confirmed in segment 6. Pathological findings of the recurrent tumor showed moderately differentiated hepatocellular carcinoma.
