Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.
Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Clin J Gastroenterol. 2021 Jun;14(3):831-835. doi: 10.1007/s12328-021-01372-z. Epub 2021 Mar 2.
Beta-catenin-activated hepatocellular adenoma is potentially malignant and warrants careful follow-up and surgical resection. Here, we report a 48-year-old man in whom a 55 mm single liver tumor was incidentally detected in the S1 segment. Contrast-enhanced computed tomography scans showed no enhancement in the early phase and a slight defection in the late phase. The tumor was enhanced hyperintensity in the hepatobiliary phase on Gd-ethoxybenzyl-diethylenetriaminepentaacetic acid-enhanced magnetic resonance imaging. The histologic features of ultrasound-guided fine-needle aspiration biopsy indicated hepatocellular adenoma, and the tumor was immunohistochemically positive for glutamine synthetase and β-catenin. Considering the risk of malignant transformation, he underwent laparoscopic-assisted partial liver resection. The resected tumor did not contain any malignant lesions. This case indicates that aspiration needle biopsy and immunohistochemistry were useful for histological diagnosis and treatment decisions based on the molecular definition of hepatocellular adenoma.
β-连环蛋白激活型肝细胞腺瘤具有潜在恶性，需要密切随访和手术切除。本文报告了 1 例 48 岁男性，在 S1 段偶然发现 1 个 55mm 的单发肝肿瘤。增强 CT 扫描在动脉早期无强化，在晚期呈轻微缺损。钆乙氧基苯甲基二乙三胺五乙酸增强磁共振成像的肝胆期肿瘤呈高增强。超声引导下细针穿刺活检的组织学特征提示肝细胞腺瘤，肿瘤免疫组化谷氨酸合成酶和β-连环蛋白阳性。鉴于恶性转化的风险，他接受了腹腔镜辅助部分肝切除术。切除的肿瘤没有任何恶性病变。该病例表明，细针穿刺活检和免疫组化对于根据肝细胞腺瘤的分子定义进行组织学诊断和治疗决策是有用的。
