title: Histologically proven hepatocellular carcinoma associated with burned-out nonalcoholic steatohepatitis.
abstract: A 64-year-old Japanese man was referred to our hospital because of liver dysfunction. He had no history of alcohol intake, diabetes, hypertension, and hyperlipidemia, and he was negative for hepatitis viral markers. His body mass index was 30.6 kg/m2. Homeostasis model assessment of insulin resistance was 6.1. Liver biopsy revealed mild steatosis, moderate inflammation, ballooning degeneration, and portal fibrosis with bridging fibrosis; on the basis of these findings, the diagnosis of nonalcoholic steatohepatitis was made. Thereafter, follow-up imaging study was performed every 4 months. At 16 months after liver biopsy, a 3 cm hepatic lesion was detected in the right hepatic lobe by computed tomography. Dynamic computed tomography revealed a hepatic tumor enhanced with contrast medium during the arterial phase and a low-density area during the portal phase. Based on the diagnosis of hepatocellular carcinoma, partial hepatectomy was performed. Histological examination revealed a moderately differentiated hepatocellular carcinoma accompanied by liver cirrhosis without steatosis or ballooning degeneration. Finally, the patient was diagnosed with hepatocellular carcinoma arising from burned-out nonalcoholic steatohepatitis.
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery,Osaka City University, Graduate School of Medicine, Japan. m1295277@msic.med.osaka-cu.ac.jp
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Kaneda
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery,Osaka City University, Graduate School of Medicine, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Uenishi
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery,Osaka City University, Graduate School of Medicine, Japan.
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Takemura
authors.affiliation: Department of Surgery, Ishikiri-Seiki Hospital, Japan.
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Yamamoto
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery,Osaka City University, Graduate School of Medicine, Japan.
authors.forename: Chikaharu
authors.initials: C
authors.lastname: Sakata
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery,Osaka City University, Graduate School of Medicine, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sakae
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery,Osaka City University, Graduate School of Medicine, Japan.
authors.forename: Yorihisa
authors.initials: Y
authors.lastname: Urata
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery,Osaka City University, Graduate School of Medicine, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Ohata
authors.affiliation: Diagnostic Pathology, Osaka City University, Graduate School of Medicine,Japan.
authors.forename: Sayaka
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Diagnostic Pathology, Osaka City University, Graduate School of Medicine,Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Wakasa
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery,Osaka City University, Graduate School of Medicine, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Kubo
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000209:etiology* / Q000473:pathology; D005234:Fatty Liver / Q000150:complications*; D006801:Humans; D008113:Liver Neoplasms / Q000209:etiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease