Treatment of a non-typical hepatic pseudolesion complicated by greatly elevated alpha fetoprotein: case report and literature review.
BACKGROUND
Hepatic pseudolesions detected by helical computed tomography (CT) are not rare, but it is difficult to make a final diagnosis when the hepatic lesion is complicated by the presence of greatly elevated alpha fetoprotein (AFP). Clinical treatment of non-typical hepatic pseudolesions complicated by greatly elevated AFP should confirm the diagnosis and minimize trauma.


METHODS
Non-invasive procedures including ultrasonography, CT, and micro-invasive digital subtraction angiography could not safely differentiate this lesion from a malignant focus when it was complicated by greatly elevated AFP. Laparoscopic hepatectomy was performed, and pathological analysis showed chronic hepatitis, nodular regenerative hyperplasia, focal nodular hyperplasia of the liver, and mild vascular malformation. The tissue was HbsAg(-), HbcAg(-), and AFP(+).


CONCLUSIONS
Heightened awareness of hepatic pseudolesion complicated by primarily elevated AFP will help physicians avoid unnecessary invasive procedures. Hepatic biopsy is inevitable because of greatly elevated AFP. For suspected hepatic pseudolesion with elevated AFP, needle-core biopsy and follow-up surveillance instead of hepatectomy are recommended to find the source of AFP and make a final diagnosis of pseudolesion.
Department of General Surgery, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, PR China. g_xlliu@126.com.
Xiao-Long
XL
Liu
Ling-Yan
LY
Zhang
Fu-Qiang
FQ
Li
Yong-Hong
YH
Liang
Qing-Zhu
QZ
Wei
Li-Xin
LX
Liu
Hai-Yan
HY
Cui
D000328:Adult; D005260:Female; D006498:Hepatectomy; D006521:Hepatitis, Chronic / Q000097:blood; D006801:Humans; D006965:Hyperplasia; D010535:Laparoscopy; D008099:Liver / Q000098:blood supply / Q000473:pathology; D008107:Liver Diseases / Q000097:blood* / Q000175:diagnosis / Q000628:therapy*; D011379:Prognosis; D014057:Tomography, X-Ray Computed; D054079:Vascular Malformations / Q000097:blood; D055815:Young Adult; D000509:alpha-Fetoproteins / Q000378:metabolism*
D000509:alpha-Fetoproteins