Atypically large well-differentiated hepatocellular carcinoma with extensive fatty metamorphosis: Report of a Case

Ishikawa, Daichi; Shimada, Mitsuo; Utsunomiya, Tohru; Morine, Yuji; Imura, Satoru; Ikemoto, Tetsuya; Mori, Hiroki; Arakawa, Yusuke; Kanamoto, Mami; Iwahashi, Shuichi; Yamada, Shinichiro; Asanoma, Michihito

doi:10.2152/jmi.60.267

Cited by 7 publications

(4 citation statements)

References 16 publications

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“…6,7 In some reports, this fatty metamorphosis was more frequent in small, well-differentiated hepatocellular carcinomas; however, with increased tumor diameter and increased histological grade, the fatty changes became infrequent. 6,7 The fatty component of these tumors also can be detected by imaging techniques, such as ultrasonography or computed tomography. 8 In some reports, fatty changes in hepatocellular carcinoma are more frequent in Asian than in non-Asian populations.…”

Section: Discussionmentioning

confidence: 96%

“…[6][7][8] Although the cause of hepatocellular carcinoma with fatty change has not been well understood, it is also considered to be related to ischemia and metabolic disorders. 6,7 In some reports, this fatty metamorphosis was more frequent in small, well-differentiated hepatocellular carcinomas; however, with increased tumor diameter and increased histological grade, the fatty changes became infrequent. 6,7 The fatty component of these tumors also can be detected by imaging techniques, such as ultrasonography or computed tomography.…”

Section: Discussionmentioning

confidence: 99%

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2014

Exp Clin Transplant

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Hepatocellular carcinoma with prominent fatty change is rare, and to date only a few cases have been reported. In this article, we present a 57-yearold woman who underwent a liver transplant for hepatocellular carcinoma. Ten months after liver transplant, she presented with a persistent cough. Computed tomography of the chest was performed, revealing a solid lung mass that measured 1 × 0.9 cm in the right inferior lobe. Right inferior lobectomy was performed, and the final diagnosis was noted as hepatocellular carcinoma with prominent fatty change. Fatty change was extensive in the tumor; therefore, lipoid pneumonia was the first condition that was considered in the differential diagnosis during examination of the lobectomy material. For the differential diagnosis, the immunohistochemistry panel was studied to show the hepatocellular nature of the tumor. Although metastasis of hepatocellular carcinoma to the lungs is expected, hepatocellular carcinoma with prominent fatty change can cause diagnostic difficulties, such as lipoid pneumonia, especially in small lung biopsies.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Untitled

2014

Exp Clin Transplant

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“…This fatty transformation is more common in tiny, well-differentiated HCC nodules, particularly those with a diameter of less than 20 mm. A well-differentiated HCC with fatty alteration is quite uncommon to progress to over 30 mm [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

A Case Presentation of Well-Differentiated Hepatocellular Carcinoma With No Sign of Liver Disease

Gedekar,

Chavhan,

Hiwale

et al. 2024

Cureus

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The type of liver cancer that occurs most frequently is hepatocellular carcinoma (HCC). The majority of cases of HCC are secondary to alcoholic cirrhosis or viral hepatitis. The presence of malignant cells with modest nuclear atypia that resemble normal hepatocytes and the lack of bare nuclei in the smears, which shows the neoplastic hepatocytes' capacity, are characteristics of a well-differentiated HCC plasma membrane to tolerate smearing. We present the case of an 83-year-old male patient with a welldifferentiated HCC, who had no etiological factors and no signs of alcohol cirrhotic liver, or any symptoms of liver disease which are the main causes of the HCC.

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“…4,5 Few case reports and no case series focusing on atypical large well-differentiated HCC (atypical-HCC) have been published. 6,7 Therefore, clinical characteristics and outcome of patients with atypical-HCC are ill-defined.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of atypical large well-differentiated hepatocellular carcinoma: a specific subtype of hepatocellular carcinoma?

Okuno

Newhook

Joechle

et al. 2020

HPB

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Background: Hepatocellular carcinoma (HCC) de-differentiation is thought to correlate with size, therefore well-differentiated HCC 3 cm are considered rare and not fully understood.Methods: Patients who underwent hepatectomy for HCC between 1998-2016 were retrospectively analyzed. Patient's characteristics and recurrence-free (RFS) and overall (OS) survival were compared between those with atypical-(well-differentiated-HCC 3 cm) and typical-HCC (moderate-to-poorlydifferentiated HCC 3 cm).Results: Of 176 patients included in this study, 37 (21%) had atypical-HCC. Patients with atypical-HCC were less likely to be Asian ethnicity (3% vs. 17%, p = 0.062), have lower rate of viral infection (14% vs. 43%, p = 0.003), cirrhosis (8% vs. 27%, p = 0.015). The tumors were less likely to demonstrate vascular invasion (30% vs. 59%, p = 0.002), and were associated with a lower alpha-fetoprotein level (3.5 ng/ml vs. 33.2 ng/ml, p < 0.001). Patients with atypical-HCC had a longer RFS (5-y RFS: 58.3% vs. 35.7%, p = 0.016) and OS (5-y OS: 79.1% vs 53.3%, p = 0.029) as compared to those with typical-HCC following univariate analysis, however this did not appear following multivariate analysis. Conclusion:Patients with atypical-HCC have different characteristic in terms of epidemiology, etiology, cirrhosis and vascular invasion as compared to typical-HCC. The etiology of atypical-HCC may be nonalcoholic fatty liver disease-related and/or malignant transformation of hepatocellular adenoma.

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Atypically large well-differentiated hepatocellular carcinoma with extensive fatty metamorphosis: Report of a Case

Cited by 7 publications

References 16 publications

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A Case Presentation of Well-Differentiated Hepatocellular Carcinoma With No Sign of Liver Disease

Characteristics of atypical large well-differentiated hepatocellular carcinoma: a specific subtype of hepatocellular carcinoma?

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