Detailed Abstract
[E-poster - Liver (Liver Disease/Surgery)]
[EP 042] Laparoscopic Extended Right Posterior Sectionectomy For Hepatocellular Carcinoma Arising From Biopsy-proven Hepatic Adenoma: A Case Report
BO-HYUN JUNG*1 , YONG-KYU CHUNG1 , HEE-JUNG WANG1
1 Department Of Surgery, Inje University Haeundae Paik Hospital, REPUBLIC OF KOREA
Background : Hepatocellular adenoma (HCA) is a rare benign liver tumor that may transform to hepatocellular carcinoma (HCC) and occurs frequently in women with a history of oral contraceptive use. We report a case of HCC arising from biopsy-proven beta-catenin negative HCA.
Methods : A 76-year-old male who diagnosed 3 cm-sized round hyperechoic mass in liver S7/8 on annual medical examination. He has a history of alcohol drinking during 30 years and diabetes mellitus. Serological tests for hepatitis B surface antigen and hepatitis C virus antibodies were negative. AFP, PIVKA and CA 19-9 were within normal range. The mass was considered to be either HCA or focal nodular hyperplasia according to the outside CT scan.
Results : He was referred to our institution and checked liver needle biopsy for that mass and had proven B-catenin negative HCA. Then, after 3 months he had regular check-up for the lesion which showed the change of size (3cm ->3.5cm) with internal necrotic change. So, He underwent laparoscopic extended right posterior sectionectomy due to the mass which seemed to expand and abut against right hepatic vein. Final pathology revealed 3.8*3.5*3.4 cm sized expanding nodular type HCC with B-catenin mutated, arising in HCA. He discharged at postoperative 8th day without problem.
Conclusions : HCA is a rare benign liver tumor and the malignant transformation of HCA into HCC is uncommon. Based on previous studies, male sex, large tumor size, exposure to steroids, underlying metabolic syndrome and activated B-catenin mutation are risk factors for malignant transformation of HCA into HCC. In this case, changes in hemodynamic status may be an important clinical sign compared with tumor size and B-catenin status.
Methods : A 76-year-old male who diagnosed 3 cm-sized round hyperechoic mass in liver S7/8 on annual medical examination. He has a history of alcohol drinking during 30 years and diabetes mellitus. Serological tests for hepatitis B surface antigen and hepatitis C virus antibodies were negative. AFP, PIVKA and CA 19-9 were within normal range. The mass was considered to be either HCA or focal nodular hyperplasia according to the outside CT scan.
Results : He was referred to our institution and checked liver needle biopsy for that mass and had proven B-catenin negative HCA. Then, after 3 months he had regular check-up for the lesion which showed the change of size (3cm ->3.5cm) with internal necrotic change. So, He underwent laparoscopic extended right posterior sectionectomy due to the mass which seemed to expand and abut against right hepatic vein. Final pathology revealed 3.8*3.5*3.4 cm sized expanding nodular type HCC with B-catenin mutated, arising in HCA. He discharged at postoperative 8th day without problem.
Conclusions : HCA is a rare benign liver tumor and the malignant transformation of HCA into HCC is uncommon. Based on previous studies, male sex, large tumor size, exposure to steroids, underlying metabolic syndrome and activated B-catenin mutation are risk factors for malignant transformation of HCA into HCC. In this case, changes in hemodynamic status may be an important clinical sign compared with tumor size and B-catenin status.
SESSION
E-poster
E-Session 03/23 ~ 03/25 ALL DAY