Abstract
Fatty changes are frequently observed in small, well-differentiated hepatocellular carcinomas (HCCs), but are rarely observed in large (over 30 mm in diameter) lesions. Here, we report a 76-year-old man who developed a large (58 mm in diameter), well-differentiated HCC with diffuse extensive fatty changes in the right lobe of the liver. He had no history of alcohol abuse, obesity, or hepatitis B or C infection, and no autoantibodies, but he did have type 2 diabetes. The serum alpha-fetoprotein level was within the normal range, and ultrasonography showed a round hyperechoic lesion. Dynamic contrast-enhanced computed tomography revealed a tumor with inhomogeneous low attenuation in the arterial, portal, and venous phases, mimicking an angiomyolipoma. The patient underwent central bisegmentectomy of the liver, and the histological diagnosis was well-differentiated HCC with diffuse extensive fatty changes. The surrounding non-cancerous area was normal. A review of the published literature found six published cases of large, well-differentiated HCC with extensive fatty changes. Unlike the patients in most previous reports, our patient did not have any underlying liver disease and had no history of alcohol abuse.
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Satoshi Komiyama, Satoshi Komiyama, Hiroshi Okazaki, Satoshi Nakao, Shuhei Nishigori, Masahiro Terada, Jun Hamanaka, Yuki Miura, Hiroyuki Oka, Fumio Suzaki and Katsuaki Tanaka declare that they have no conflict of interest.
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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and its later amendments.
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Informed consent was obtained from all patients for being included in the study.
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Komiyama, S., Okazaki, H., Nakao, S. et al. Diffuse fatty metamorphosis of a large, well-differentiated hepatocellular carcinoma originating in the normal liver: a case report and literature review. Clin J Gastroenterol 8, 345–350 (2015). https://doi.org/10.1007/s12328-015-0606-7
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DOI: https://doi.org/10.1007/s12328-015-0606-7