J Liver Cancer.  2021 Mar;21(1):87-91. 10.17998/jlc.21.1.87.

Hepatocellular Carcinoma Arising from Hepatocellular Adenoma in an Elderly Male Patient

Affiliations
  • 1Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Abstract

Hepatocellular adenoma is a benign tumor of the liver occurring predominantly in young women taking oral contraceptives. The malignant transformation of hepatocellular adenoma into hepatocellular carcinoma has rarely been reported. Herein, we report the case of an elderly male patient with hepatocellular carcinoma that developed from hepatocellular adenoma. The patient’s high risk for surgery and conflicting biopsy and imaging results made it difficult to determine the treatment direction. Eventually, the mass was completely removed by laparoscopic left hemi-hepatectomy without complications.

Keyword

Hepatocellular adenoma; Hepatocellular carcinoma; Aged; Minimal invasive surgery

Figure

  • Figure 1 Radiologic findings of the hepatic mass. Initial contrast-enhanced computed tomography revealed a 4.5-cm-sized mass in segment 4 with heterogeneous arterial enhancement (A) and delayed washout (B). The lesion had no central scar and was compatible with hepatocellular carcinoma.

  • Figure 2 Radiologic findings of the hepatic mass. Magnetic resonance imaging revealed a 4.5 cm-sized mass with heterogeneous arterial reinforcement (A) and delayed loss (B), compatible with computed tomography findings.

  • Figure 3 Radiologic findings of the hepatic mass after 1 year of follow-up. The mass increased in size to 5.5 cm, and no other significant changes were noted compared to the previous computed tomography scan (A) arterial phase, (B) delayed phase.

  • Figure 4 Gross specimen findings of the hepatic mass. The gross findings showed an expanding nodular type and a fat-containing mass.

  • Figure 5 Microscopic pathological findings of the hepatic mass. The hepatocellular adenoma (HCA) part showed an adenoma portion composed of benign-looking hepatocytes without portal tracts, and the hepatocellular carcinoma (HCC) part showed increased cellularity and was judged as Edmonson grade 1–2, consistent with HCC (original magnification, ×40).


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