title: Case of clear-cell hepatocellular carcinoma that developed in the normal liver of a middle-aged woman.
abstract: A 36-year-old woman was admitted to our department for close examination of a liver tumor that was found during a medical checkup. Abdominal US, CT and MRI showed a tumor in segment 7 (S7) of the liver. Although imaging suggested hepatocellular carcinoma, laboratory tests showed no abnormality in liver function, hepatitis virus markers were negative, and tumor markers including protein induced by vitamin K absence or antagonist II (PIVKA-II), alpha-fetoprotein (AFP), carbohydrate antigen 19-9 (CA19-9), and carcinoembryonic antigen (CEA) were all within normal ranges. Upon aspiration biopsy of the liver, the histopathological diagnosis was moderately differentiated hepatocellular carcinoma. Therefore, right hepatectomy was performed. Although a part of the tumor was necrotic, about 60% of the viable part showed a clear-cell variant. Consequently, it was diagnosed as clear-cell hepatocellular carcinoma. It was noted that the background liver tissue was normal. This case is worthy of reporting because development of clear-cell hepatocellular carcinoma in the normal liver of a middle-aged woman is rarely seen.
authors.affiliation: Department of Internal Medicine II, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Japan. junior@fmu.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takahashi
authors.forename: Hironobu
authors.initials: H
authors.lastname: Saito
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Kanno
authors.forename: Kazumichi
authors.initials: K
authors.lastname: Abe
authors.forename: Junko
authors.initials: J
authors.lastname: Yokokawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Irisawa
authors.forename: Akira
authors.initials: A
authors.lastname: Kenjo
authors.forename: Takuro
authors.initials: T
authors.lastname: Saito
authors.forename: Mitsukazu
authors.initials: M
authors.lastname: Gotoh
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Ohira
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000601:surgery; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000473:pathology* / Q000502:physiology* / Q000601:surgery; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery