title: Atypically large well-differentiated hepatocellular carcinoma with extensive fatty metamorphosis: report of a case.
abstract: A large well-differentiated hepatocellular carcinoma (HCC) with fatty change is rare, and to date only a few cases have been reported. Herein, we present a 68-year-old man who developed a well-differentiated HCC with extensive fatty metamorphosis. The patient was referred to our institute because of a rapidly growing tumor in the left lobe of the liver. Ultrasonography showed a hyperechoic lesion with a peripheral hypoechoic area. Dynamic contrast-enhanced computed tomography (CT) scan in all three phases revealed the tumor which showed diffuse low attenuation with internal irregular enhancement. He underwent left lateral segmentectomy at the liver. Histological diagnosis confirmed well-differentiated HCC and the surrounding non-cancerous area was diagnosed as non-alcoholic steatohepatitis. The patient is still alive without recurrence after 17 months of follow-up.
authors.affiliation: The Department of Surgery, the University of Tokushima.
authors.forename: Daichi
authors.initials: D
authors.lastname: Ishikawa
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Shimada
authors.forename: Tohru
authors.initials: T
authors.lastname: Utsunomiya
authors.forename: Yuji
authors.initials: Y
authors.lastname: Morine
authors.forename: Satoru
authors.initials: S
authors.lastname: Imura
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ikemoto
authors.forename: Hiroki
authors.initials: H
authors.lastname: Mori
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Arakawa
authors.forename: Mami
authors.initials: M
authors.lastname: Kanamoto
authors.forename: Shuichi
authors.initials: S
authors.lastname: Iwahashi
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Yamada
authors.forename: Michihito
authors.initials: M
authors.lastname: Asanoma
mesh_terms: D000368:Aged; D018207:Angiomyolipoma / Q000175:diagnosis; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000473:pathology* / Q000601:surgery; D002454:Cell Differentiation; D003937:Diagnosis, Differential; D005234:Fatty Liver / Q000150:complications / Q000473:pathology; D006801:Humans; D008068:Lipomatosis / Q000150:complications / Q000473:pathology*; D008113:Liver Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease