A case of hepatocellular carcinoma accompanied by adenomatous hyperplasia and borderline lesion of hepatoma pathologically

One of the tumors was deposited with lipiodol and the other was not with lipiodol simultaneously

Abstract

55 year old male admitted to our hospital because of the elevation of serum a-fetoprotein and hypoechoic mass on ultrasonography. He had been followed up as liver cirrhosis with positive HBsAg. Two hypervascular tumors with diameter of 2cm×3cm were found in right lobe on angiography, transcatheter arterial embolization (TAE) with Adriamycin + Lipiodol was done twice. Blood transfusion was needed for bleeding from duodenal ulcer after TAE and transcatheter splenic arterial embolization (TSAE) was done as preoperative treatment for the improvement of hypersplenism. One month after TSAE, hepatic failure became worsen and died three month after admission. Lipiodol was deposited to one tumor and not to the other one on computed tomography. Microscopically, the former was completely necrotic, and the other was viable, containing hepatocellular carcinoma (Edmondson II). Adenomatous hyperplasia containing the borderline lesion of hepatocellular carcinoma were found in the other part of the liver. These findings seems to support the multicentric origin theory of hepatocellular carcinoma.