Total necrosis of hepatocellular carcinoma due to spontaneous occlusion of feeding artery.
Spontaneous total necrosis of hepatocellular carcinoma is extremely rare, with only 15 cases reported to date in the English literature, and the involved mechanism remains unresolved. This paper describes a case of spontaneous necrosis of hepatocellular carcinoma in a 70-year-old man with chronic hepatitis. The patient suffered epigastric pain on admission and computed tomography revealed a 4 cm mass with low density in the left lobe of the liver. Fine needle aspiration biopsy revealed a few scattered, naked and irregular nuclei exhibiting nuclear hyperchromasia in the dirty necrotic background, a finding highly suggestive of malignancy. The lobectomized liver revealed a 3.5 cm, well encapsulated, round, and nearly totally necrotic mass. On microscopic examination, the tumor was found to be composed of thick trabeculae of necrotic tumor cells, supporting the diagnosis of hepatocellular carcinoma. After surgery and throughout 13 months of follow up the patient has recovered well.
Lee
Sang Cheol
SC
Department of Internal Medicine, Yonsei University College of Medicine, C.P.O. Box 8044, Seoul 120-752, Korea.
Chung
Hye Won
HW
Chung
Jae Bock
JB
Park
Young Nyun
YN
Ahn
Sang Hoon
SH
Park
Seung Woo
SW
Chun
Chae Yoon
CY
Moon
Young Myoung
YM
Kang
Jin Kyung
JK
Park
In Suh
IS
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D009336:Necrosis; D013927:Thrombosis / Q000473:pathology*