Matsuda Masanori, Amemiya Hidetake, Kawaida Hiromichi, Okamoto Hirotaka, Hosomura Naohiro, Asakawa Masami, Sano Katsuhiro, Motosugi Utaroh, Ichikawa Tomoaki, Nakazawa Tadao, Fujii Hideki
First Department of Surgery, Yamanashi University School of Medicine, 1110 Shimokato, Chuo-city, Yamanashi, 409-3898, Japan,
Surg Today. 2014 Jul;44(7):1359-66. doi: 10.1007/s00595-013-0653-y. Epub 2013 Jul 5.
We report a case of typical fibrolamellar hepatocellular carcinoma (FL-HCC) in a 16-year-old Japanese boy. This is very rare malignancy in Japan. The patient was referred for investigation of a large hepatic tumor and the results of tests for hepatitis B virus surface antigen and hepatitis C virus antibody were negative. Liver function test results and serum alpha-fetoprotein (AFP) levels were normal; however, the prothrombin induced by vitamin K absence/antagonist II was elevated. Computed tomography (CT) showed a large lobulated heterogeneously enhanced tumor in the posterior section of the liver. We diagnosed FL-HCC and performed posterior sectionectomy of the liver. The resected specimen contained a light brown and green tumor with a central fibrous scar, 10.0 cm in diameter. Microscopic and electron microscopic examinations revealed the typical features of FL-HCC. Immunohistochemically, the tumor cells were positive for cytokeratin (CK) 7, but negative for CK19 and AFP. The patient was alive without recurrence 48 months after surgery. Following this case report, we summarize the clinical features of the Japanese cases documented in the literature.
我们报告了一例16岁日本男孩的典型纤维板层型肝细胞癌（FL-HCC）病例。这在日本是一种非常罕见的恶性肿瘤。该患者因肝脏巨大肿瘤前来检查，乙肝病毒表面抗原和丙肝病毒抗体检测结果均为阴性。肝功能检查结果和血清甲胎蛋白（AFP）水平正常；然而，维生素K缺乏/拮抗剂-II诱导的凝血酶原升高。计算机断层扫描（CT）显示肝脏后段有一个大的分叶状、不均匀强化的肿瘤。我们诊断为FL-HCC并进行了肝脏后段切除术。切除的标本包含一个直径10.0厘米、带有中央纤维瘢痕的浅棕色和绿色肿瘤。显微镜和电子显微镜检查揭示了FL-HCC的典型特征。免疫组化显示，肿瘤细胞细胞角蛋白（CK）7呈阳性，但CK19和AFP呈阴性。患者术后48个月存活且无复发。在该病例报告之后，我们总结了文献中记录的日本病例的临床特征。
