title: Liver cell adenoma with malignant transformation: a case report.
abstract: A 57-year-old woman was referred to our hospital because of a liver mass detected by computed tomography. She had taken oral contraceptives for only one month at the age of thirty. Physical examination revealed no abnormalities, and laboratory data, including hepatic function tests, were within the normal range, with the exception of elevated levels of those serum proteins induced by the absence of vitamin K or by raised levels of the antagonist (PIVKA)-II (3,502 AU/ml). Abdominal ultrasonography revealed a hyperechoic mass measuring 10 X 10 cm in the left posterior segment of the liver. Because hepatocellular carcinoma could not be completely excluded, this mass was resected. The tumor consisted of sheets of uniform cells with clear cytoplasm, perinuclear eosinophilic granules and round nuclei. These histological findings were consistent with liver cell adenoma. Background hepatic tissue appeared normal. After resection of the tumor, serum PIVKA-II fell to within the normal range. An area of hepatocellular carcinoma (HCC) with a mid-trabecular pattern was immunohistochemically found, which was positive for PIVKA-II. Sinusoidal endothelial cells were CD34-positive, containing scattered PIVKA-II positive cells. This tumor was therefore finally diagnosed as liver cell adenoma with focal malignant transformation to HCC.
authors.affiliation: Department of Pathology, National Nagasaki Medical Center, Omura City, Nagasaki 856-856, Japan. itohm@nmc.hosp.go.jp
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ito
authors.forename: Makoto
authors.initials: M
authors.lastname: Sasaki
authors.forename: Chun Yang
authors.initials: CY
authors.lastname: Wen
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakashima
authors.forename: Toshihito
authors.initials: T
authors.lastname: Ueki
authors.forename: Hiromi
authors.initials: H
authors.lastname: Ishibashi
authors.forename: Michitami
authors.initials: M
authors.lastname: Yano
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kage
authors.forename: Masamichi
authors.initials: M
authors.lastname: Kojiro
mesh_terms: D000236:Adenoma / Q000473:pathology*; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D002471:Cell Transformation, Neoplastic; D003276:Contraceptives, Oral; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008875:Middle Aged
chemical_list: D003276:Contraceptives, Oral