Abstract
Clear cell hepatocellular carcinoma (CC-HCC) is a rare type of hepatocellular carcinoma (HCC), characterized by seat-like proliferation of large carcinoma cells with clear cytoplasm. Scirrhous hepatocellular carcinoma (SC-HCC) is also reported as a histologic variant of HCC, characterized by extensive fibrosis of the tumor.
A 56-year old man was found to have a heterogeneously enhanced round mass in the right lobe of the liver on dynamic enhanced computed tomography (CT). Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) revealed a total of three tumors. Two tumors were located in segment 8 and the third in segment 6. Serum tumor markers revealed elevated alpha-fetoprotein 14.7 ng/mL and Protein Induced by Vitamin K Absence/antagonist II 1020 mAU/mL. These findings suggested triple HCCs in total, in segment 6 and 8 of the liver, and the patient underwent partial resection of segments 6 and 8. The microscopic findings of the resected specimens in segment 8 demonstrated that one was compatible with CC-HCC, and the other with SC-HCC. The tumor in segment 6 was diagnosed as a well-differentiated HCC. To our knowledge, this is the first report of hepatocellular carcinoma with co-existence CC-HCC and SC-HCC in the same liver segment.
