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Panminerva Medica 2000 June;42(2):151-4

lingua: Inglese

Hepatocellular carcinoma in a non-cirrhotic liver. Two case reports and literature review

Leone N., Volpes R., Carrera M. *, Pellicano R., De Paolis P. *, Fiorentino M. **, Fronda G. R., Rizzetto M.

From the Department of Gastroenterology
*B Surgery Molinette Hospital, Turin, Italy
**Pathology, Addari Institute, Bologna, Italy


Hepatocellular car­ci­no­ma (HCC) is close­ly asso­ciat­ed ­with cir­rho­sis, but it ­also devel­ops, ­although ­much ­less fre­quent­ly, in a non-cir­rhot­ic liv­er. It is sus­pect­ed ­that hepat­o­cel­lu­lar car­ci­no­ma has a dif­fer­ent eti­ol­o­gy ­when asso­ciat­ed and not asso­ciat­ed ­with chron­ic liv­er dis­ease. We ­report two cas­es of ­patients ­with hepat­o­cel­lu­lar car­ci­no­ma ­that devel­oped in a non-cir­rhot­ic liv­er. In the ­first ­case we ­describe an inci­den­tal liv­er nod­u­lar ­lesion con­tain­ing mul­ti­ple ­foci of HCC includ­ing pseu­do­gland or tra­bec­u­lar for­ma­tion and are­as of scler­o­sis. The non-can­cer­ous paren­chy­ma of the liv­er was his­to­log­i­cal­ly unre­mark­able ­except for ­mild fat­ty chang­es of hep­a­toc­y­tes and min­i­mal dys­pla­sia. The sec­ond ­case ­describes a com­bined hepat­o­cel­lu­lar car­ci­no­ma and cho­lan­gio­cel­lu­lar car­ci­no­ma (CCC) (­mixed car­ci­no­ma) in a ­patient who was ser­o­log­i­cal­ly neg­a­tive for ­both hep­a­titis B and C virus­es. The adja­cent liv­er paren­chy­ma ­showed ­mild piece­meal necro­sis and ­mild lob­u­lar activ­ity com­pat­ible ­with chron­ic ­viral hep­a­titis, but cir­rho­sis was not estab­lished. This ­case ­appears to indi­cate ­that ­mixed ­type car­ci­no­ma can devel­op in a non-cir­rhot­ic liv­er, ­with CCC ­being far ­more dom­i­nant ­than HCC; ­such a find­ing is extreme­ly unusu­al, ­based on pre­vi­ous­ly pub­lished ­reports.

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