Case Report
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jan 7, 2008; 14(1): 129-131
Published online Jan 7, 2008. doi: 10.3748/wjg.14.129
Case of clear-cell hepatocellular carcinoma that developed in the normal liver of a middle-aged woman
Atsushi Takahashi, Hironobu Saito, Yukiko Kanno, Kazumichi Abe, Junko Yokokawa, Atsushi Irisawa, Akira Kenjo, Takuro Saito, Mitsukazu Gotoh, Hiromasa Ohira
Atsushi Takahashi, Hironobu Saito, Yukiko Kanno, Kazumichi Abe, Junko Yokokawa, Atsushi Irisawa, Hiromasa Ohira, Department of Internal Medicine II, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Japan
Akira Kenjo, Takuro Saito, Mitsukazu Gotoh, Department of Surgery I, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Japan
Correspondence to: Atsushi Takahashi, Department of Internal Medicine II, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Japan. junior@fmu.ac.jp
Telephone: +81-24-5471202
Fax: +81-24-5472055
Received: July 17, 2007
Revised: October 8, 2007
Published online: January 7, 2008
Abstract

A 36-year-old woman was admitted to our department for close examination of a liver tumor that was found during a medical checkup. Abdominal US, CT and MRI showed a tumor in segment 7 (S7) of the liver. Although imaging suggested hepatocellular carcinoma, laboratory tests showed no abnormality in liver function, hepatitis virus markers were negative, and tumor markers including protein induced by vitamin K absence or antagonist II (PIVKA-II), α-fetoprotein (AFP), carbohydrate antigen 19-9 (CA19-9), and carcinoembryonic antigen (CEA) were all within normal ranges. Upon aspiration biopsy of the liver, the histopathological diagnosis was moderately differentiated hepatocellular carcinoma. Therefore, right hepatectomy was performed. Although a part of the tumor was necrotic, about 60% of the viable part showed a clear-cell variant. Consequently, it was diagnosed as clear-cell hepatocellular carcinoma. It was noted that the background liver tissue was normal. This case is worthy of reporting because development of clear-cell hepatocellular carcinoma in the normal liver of a middle-aged woman is rarely seen.

Keywords: Clear-cell hepatocellular carcinoma; Liver; Middle-aged