title: Total necrosis of hepatocellular carcinoma due to spontaneous occlusion of feeding artery.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, C.P.O. Box 8044, Seoul 120-752, Korea.
authors.forename: Sang Cheol
authors.initials: SC
authors.lastname: Lee
authors.forename: Hye Won
authors.initials: HW
authors.lastname: Chung
authors.forename: Jae Bock
authors.initials: JB
authors.lastname: Chung
authors.forename: Young Nyun
authors.initials: YN
authors.lastname: Park
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Ahn
authors.forename: Seung Woo
authors.initials: SW
authors.lastname: Park
authors.forename: Chae Yoon
authors.initials: CY
authors.lastname: Chun
authors.forename: Young Myoung
authors.initials: YM
authors.lastname: Moon
authors.forename: Jin Kyung
authors.initials: JK
authors.lastname: Kang
authors.forename: In Suh
authors.initials: IS
authors.lastname: Park
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D009336:Necrosis; D013927:Thrombosis / Q000473:pathology*