title: Hepatocellular carcinoma associated with sarcoidosis.
abstract: BACKGROUND
  The association of hepatic sarcoidosis with hepatocellular carcinoma (HCC) is considerably rare. Here we report a rare case of HCC associated with sarcoidosis.
  
  
  METHODS
  A 75-year-old male with no history of alcohol addiction or viral hepatitis was referred to our hospital because of an abnormal liver mass. Subsegmentectomy of the liver was performed for the diagnosis of HCC. A histopathological examination revealed small non-necrotizing granulomas with a tendency to coalesce that were scattered in and around the carcinoma. No features of cirrhosis, steatohepatitis, and any other liver diseases were observed. Furthermore, swelling of the bilateral lung hilar lymph nodes with uptake of 18F-fluorodeoxyglucose was found on positron emission tomography/computed tomography and the tuberculin reaction test results were negative. On the basis of these findings, the final diagnosis of HCC associated with sarcoidosis was confirmed.
  
  
  CONCLUSIONS
  By reviewing previous cases, we found only five cases that described patients diagnosed with HCC associated with sarcoidosis. Of these, four patients died within two years after diagnosis because of ruptures or inoperable huge tumors. In contrast, radical hepatectomy was performed at an earlier stage of disease in two patients, including ours, and both these patients have remained healthy with no recurrences or metastases at the latest follow-up visit.
  
  
  CONCLUSIONS
  Periodic checkups of the liver should be conducted for patients with systemic sarcoidosis, regardless of the presence of liver cirrhosis.
authors.affiliation: Department of Surgery, Okaya Municipal Hospital, Hon-machi 4-11-33, Okaya 394-8512, Japan. Electronic address: t-arai@gd5.so-net.ne.jp.
authors.forename: Takuma
authors.initials: T
authors.lastname: Arai
authors.affiliation: Department of Surgery, Okaya Municipal Hospital, Hon-machi 4-11-33, Okaya 394-8512, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Akita
authors.affiliation: Department of Surgery, Okaya Municipal Hospital, Hon-machi 4-11-33, Okaya 394-8512, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sakon
authors.affiliation: Department of Surgery, Okaya Municipal Hospital, Hon-machi 4-11-33, Okaya 394-8512, Japan.
authors.forename: Taishi
authors.initials: T
authors.lastname: Fujii
authors.affiliation: Department of Surgery, Okaya Municipal Hospital, Hon-machi 4-11-33, Okaya 394-8512, Japan.
authors.forename: Haruki
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Department of Pathology, Okaya Municipal Hospital, Hon-machi 4-11-33, Okaya 394-8512, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Ishii
authors.affiliation: Department of Surgery, Okaya Municipal Hospital, Hon-machi 4-11-33, Okaya 394-8512, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Miwa
keywords: Hepatocellular carcinoma; Liver; Sarcoidosis