Voluminous fibrolamellar carcinoma in a young adult: A case report.

INTRODUCTION

Fibrolamellar carcinoma (FLC) is a rare primary liver cancer, typically presenting as a solitary nodule in young adults without underlying liver disease. Surgical resection is currently the only curative treatment.

PRESENTATION OF CASE

We report a 27-year-old woman with a 6-month history of moderate epigastric pain, right upper quadrant heaviness, and a 20-kg weight loss. Imaging studies (ultrasound, CT, and MRI) revealed an 11-cm mass in the right liver featuring a central scar and calcifications, highly suggestive of FLC. A liver biopsy confirmed the diagnosis. The patient subsequently underwent a right hepatectomy with en bloc resection of an adherent diaphragmatic collar and lymphadenectomy. Her postoperative course was uneventful, leading to discharge on postoperative day 10.

DISCUSSION

FLC accounts for less than 1 % of primary liver tumors and is distinct from conventional hepatocellular carcinoma, primarily due to its occurrence in non-cirrhotic, younger patients. Characteristic radiologic findings include a well-circumscribed, large lesion with a central fibrous scar and occasional calcifications. Although the prognosis post-resection is generally favorable, recurrence rates exceed 60 %, emphasizing the need for aggressive surgical management and vigilant long-term follow-up.

CONCLUSION

FLC is a distinct clinical entity with improved surgical outcomes compared to classical hepatocellular carcinoma. Nonetheless, its high recurrence potential necessitates continued surveillance and further research to optimize treatment strategies.