著明な嚢胞形成を伴った肝細胞癌の１自験例

It is said that in hepatocellular carcinoma, necrosis is liable to occur in the center and
the percentage of cystic formation is comparatively low, but as we have experienced one
case of hepatocellular carcinoma associated with marked cystic formation, we reported it.
The patient was a female aged７０years. Because general fatigue and anorexia occurred,
Abdominal CT test was conducted and hepatic mass was pointed out. Contrast-CT test
showed a tumor of６cm in diameter in the medial segment of the left lobe of the liver. As
the border was stained with arterial phase, the center was not imaged and the tumor was
diagnosed as vascular proliferating type hepatic tumor associated with marked cystic
change. MRI test showed that the border of the tumor was lobular and part thereof was of
septal structure. The tumor was diagnosed as hepatocellular carcinoma associated with
bleeding in tumor, hepatic cystadenocarcinoma or hepatic sarcoma. Abdominal angiography
showed not only marked vascular proliferation and tumor stain in the area of the middle
hepatic artery but also early venous return, and the middle hepatic vein was clearly imaged.
The tumor size was ５×５×４cm in size and was in contact with the middle hepatic vein
but it did not invade the vein. Left hepatic lobectomy was performed. Histopathologically
the center of the tumor was cystic with colliquative necrosis. The tumor had the trabecular
structure and the tumor cell was consisted of clear cell. The tumor was thus diagnosed as
poorly differentiated hepatocellular carcinoma. Postoperative course was good and the patient
was discharged from our hospital on the１９th day after operation. At the moment when１９
months have passed since the operation, the patient is alive without any recurrence of
carcinoma.

四国医学雑誌 : http://www.tokushima-u.ac.jp/med/research/shikoku_acta_medica.html