The patient, a 74-year-old man with a history of
alcoholic hepatitis, was referred to our hospital for confirmation of suspected HCC. In March 2015, abdominal ultrasonography detected a low echoic mass in segment 8 (S8) of the liver. Contrast-enhanced computed tomography (CT) imaging revealed interval growth of this
tumor and showed that the
tumor was well enhanced in the arterial phase and washed out in the portal and delayed phases. The serum
alpha-fetoprotein level was elevated at 30.8ng/mL and the percentage of the L3
isoform was 25.5%. Two months later, CT imaging showed that the
tumor was of low density and had decreased in size; no contrast enhancement of the
tumor was seen. Spontaneous
necrosis of the HCC was considered; however, as we could not exclude viable malignant cells in the
tumor, we performed S8
segmentectomy of the liver. The resected
tumor specimen had a thick fibrous
capsule. Histopathological findings showed only granulation and necrotic tissue accompanied by
bleeding and
hemosiderosis. No viable
tumor cells were observed. The serum
alpha-fetoprotein level returned to the normal range one month after surgery.
DISCUSSION: