Rapidly enlarged inflammatory hepatocellular adenoma: A case report

Kenji Koneri, Hidetaka Kurebayashi, Katsuji Sawai, Yasuo Hirono, Mitsuhiro Morikawa, Makoto Murakami, Takanori Goi, Atsushi Iida, Kanji Katayama, Hiroshi Itoh, Motoko Sasaki, Yasuni Nakanuma, Akio Yamaguchi

Department of Gastroenterological Surgery, University of Fukui, Fukui, Japan.
Department of Human Pathology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan.
Department of Tumor Pathology, University of Fukui, Fukui, Japan.

DOI: 10.4236/ojgas.2013.34038                

Abstract

We present a rare case of rapidly enlarging inflamematory hepatocellular adenoma (IHCA) in a 60-year-old Japanese man. Screening abdominal computed tomography (CT) for the fatty liver patient revealed a 1.7-cm liver mass in the anterior segment of the liver. After 19 months, the lesion had rapidly enlarged to 6 cm in diameter and the patient was referred to our hospital. On perflubutane microbubble contrast-enhanced ultrasonography, the tumor showed a characteristic centripetal filling pattern in the vascular phase. We performed hepatic anterior segment resection because we could not rule out malignant tumor. Histopathological examination showed hyperplasia of mildly atypical hepatocytes and sinusoidal dilatation with marked inflammatory cell infiltration. Immunohistological staining revealed positive staining for serum amyloid A and C-reactive protein; therefore, we diagnosed this tumor as IHCA. The patient remains alive 42 months after operation without evidence of recurrence.

Keywords

Inflammatory Hepatocellular Adenoma; Perflubutane Microbubble Contrast-Enhanced Ultrasonography; Surgery; Rapid Enlargement

Conflicts of Interest

The authors declare no conflicts of interest.

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