title: Development of well-differentiated hepatocellular carcinoma in large adenomatous hyperplasia after long-term follow-up: a case report.
abstract: This report describes a 63-year-old man with a large adenomatous hyperplasia that had been followed over 10 years without any apparent change of size or profile, but grew rapidly after completion of interferon therapy. This patient was a sustained responder, in whom serum alanine aminotransferase levels remained within the normal range and the serum hepatitis C virus-RNA level was undetectable after completion of interferon therapy. However, the tumors, located in segments 5 and 8 of the liver, which had both been followed as adenomatous hyperplasia, grew rapidly two months after completion of interferon therapy; imaging modalities revealed that the former was a typical hepatocellular carcinoma and the latter a large adenomatous hyperplasia. The patient underwent right paramedian sectoriectomy of the liver. Histological examination showed that the tumor in segment 8 had mosaic proliferation of hepatocytes without fibrosis, indicating adenomatous hyperplasia, in which a small focus of well-differentiated hepatocellular carcinoma was present. This case suggests that even in sustained responders to interferon, administration of this drug cannot suppress malignant transformation of adenomatous hyperplasia to hepatocellular carcinoma. One year after surgery, the patient is doing well without signs of recurrence.
authors.affiliation: Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Midorikawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Keiichi
authors.initials: K
authors.lastname: Kubota
authors.forename: Masaya
authors.initials: M
authors.lastname: Mori
authors.forename: Tadatoshi
authors.initials: T
authors.lastname: Takayama
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Makuuchi
mesh_terms: D018248:Adenoma, Liver Cell / Q000473:pathology / Q000601:surgery*; D006528:Carcinoma, Hepatocellular / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D002471:Cell Transformation, Neoplastic / Q000139:chemically induced* / Q000473:pathology; D005500:Follow-Up Studies; D006498:Hepatectomy; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D006965:Hyperplasia; D016899:Interferon-beta / Q000009:adverse effects* / Q000627:therapeutic use; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D016899:Interferon-beta