Adult-type hepatocellular carcinoma in the center of a fibrolamellar hepatocellular carcinoma.
A large hepatic tumor was detected in the noncirrhotic liver of a 27-year-old female patient. The tumor was radiologically characterized by a peripheral mass encircling a central ovoid tumor, and was resected by an extended right hemihepatectomy. Histologic examination revealed that the peripheral and major component of the tumor represented a fibrolamellar hepatocellular carcinoma, whereas the central, well-demarcated tumor was a less well-differentiated adult-type hepatocellular carcinoma completely encircled by the former. Cells of the peripheral tumor mass abundantly expressed cytokeratin-7, typically present in the fibrolamellar variant, whereas no cytokeratin-7 immunoreactivity was found in the central tumor. To our knowledge, this is the first reported case of a not admixed but clearly separated evolution of these 2 histologic patterns within the same tumor, and suggests that the 2 types of hepatocellular carcinoma may share a common pathogenic pathway.
Department of Visceral and Transplantation Surgery and the Institute of Pathology, University of Berne, Berne, Switzerland.
Guido
G
Seitz
Arthur
A
Zimmermann
Helmut
H
Friess
Markus W
MW
Büchler
D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis; D006528:Carcinoma, Hepatocellular / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053552:Keratin-7; D007633:Keratins / Q000032:analysis; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D009378:Neoplasms, Multiple Primary / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; C507497:KRT7 protein, human; D053552:Keratin-7; D007633:Keratins