Case Report
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Mar 14, 2009; 15(10): 1267-1272
Published online Mar 14, 2009. doi: 10.3748/wjg.15.1267
Liver cell adenoma showing sequential alteration of radiological findings suggestive of well-differentiated hepatocellular carcinoma
Takayuki Kogure, Yoshiyuki Ueno, Satoshi Sekiguchi, Kazuyuki Ishida, Takehiko Igarashi, Yuta Wakui, Takao Iwasaki, Tooru Shimosegawa
Takayuki Kogure, Yoshiyuki Ueno, Yuta Wakui, Takao Iwasaki, Tooru Shimosegawa, Division of Gastroenterology, Graduate School of Medicine, Tohoku University, Sendai 980-8574, Japan
Satoshi Sekiguchi, Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, Sendai 980-8574, Japan
Kazuyuki Ishida, Department of Pathology, Tohoku University Hospital, Sendai 980-8574, Japan
Takehiko Igarashi, Division of Gastroenterology Osaki Citizen Hospital, Furukawa 989-6183, Japan
Author contributions: Kogure T, Ueno Y and Wakui Y participated in writing of the manuscript; Kogure T, Ueno Y, Iwasaki T, Shimosegawa T, Sekiguchi S, Ishida K, and Igarashi T participated in treatment of the patient.
Correspondence to: Yoshiyuki Ueno, MD, PhD, Division of Gastroenterology, Graduate School of Medicine, Tohoku University, 1-1 Seiryo, Aoba-ku, Sendai 980-8574, Japan. yueno@mail.tains.tohoku.ac.jp
Telephone: +81-22-7177171
Fax: +81-22-7177177
Received: September 25, 2008
Revised: November 1, 2008
Accepted: November 8, 2008
Published online: March 14, 2009
Abstract

A liver tumor 35 mm in diameter was found incidentally in a 40-year-old woman who had no history of liver diseases or the use of oral contraceptives. Radiological diagnostics showed the typical findings of liver cell adenoma (LCA). Dynamic computed tomography revealed that the tumor showed a homogenous enhancement in the arterial phase and almost the same enhancement as the surrounding liver parenchyma in the delayed phase. The tumor was found to contain fat on magnetic resonance imaging. A benign fat containing liver tumor was suggested. However, radiological findings altered, which caused us to suspect that a well-differentiated hepatocellular carcinoma (HCC) containing fat was becoming dedifferentiated. Partial hepatectomy was performed and the pathological findings showed the typical findings of LCA. This case was an extremely rare LCA, which had no background of risk for LCA and developed the sequential alteration of the radiological findings to suspect well-differentiated HCC.

Keywords: Liver cell adenoma; Hepatocellular carcinoma; Diagnosis; Hepatectomy