Rapidly enlarged inflammatory hepatocellular adenoma: A case report

DOI: 10.4236/ojgas.2013.34038   PDF   HTML     3,602 Downloads   5,567 Views  


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.

Share and Cite:

Koneri, K. , Kurebayashi, H. , Sawai, K. , Hirono, Y. , Morikawa, M. , Murakami, M. , Goi, T. , Iida, A. , Katayama, K. , Itoh, H. , Sasaki, M. , Nakanuma, Y. and Yamaguchi, A. (2013) Rapidly enlarged inflammatory hepatocellular adenoma: A case report. Open Journal of Gastroenterology, 3, 227-230. doi: 10.4236/ojgas.2013.34038.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Bioulac-Sage, P., Rebouissou, S., Thomas, C., Blanc, J.F., Saric, J., Cunha, A.S., Rullier, A., Cubel, G., Couchy, G., Imbeaud, S., et al. (2007) Hepatocellular adenoma subtype classification using molecular markers and immuno-histochemistry. Hepatology, 46, 740-748. doi:10.1002/hep.21743
[2] Zucman-Rossi, J., Jeannot, E., Nhieu, J.T., Scoazec, J.Y., Guettier, C., Rebouissou, S., Bacq, Y., Leteurtre, E., Paradis, V., Michalak, S., etal. (2006) Genotype-phenotype correlation in hepatocellular adenoma: New classification and relationship with HCC. Hepatology, 43, 515-524. doi:10.1002/hep.21068
[3] Bioulac-Sage, P., Balabaud, C. and Wanless, I. (2000) Focal nodular hyperplasia and hepatocellular adenoma. In: Bosman, F., Ed., WHO classification of tumours of the digestive system. 4th Edition, IARC, Lyon, 198-204.
[4] Rebouissou, S., Amessou, M., Couchy, G., Poussin, K., Imbeaud, S., Pilati, C., Izard, T., Balabaud, C., Bioulac-Sage, P. and Zucman-Rossi, J. (2009) Frequent in-frame somatic deletions activate gp130 in inflammatory heaptocellular tumours. Nature, 457, 200-204. doi:10.1038/nature07475
[5] Sasaki, M., Yoneda, N., Kitamura, S., Sato, Y. and Nakanuma, Y. (2011) Characterization of hepatocellular adenoma based on the phenotypic classification: The Kanazawa experience. Hepatology Research, 41, 982-988. doi:10.1111/j.1872-034X.2011.00851.x
[6] Paradis, V., Champault, A., Ronot, M., Deschamps, L., Valla, D.C., Vidaud, D., Vilgrain, V., Belghiti, J. and Bedossa, P. (2007) Telangiectatic adenoma: An entity associated with invreased body mass index and inflammation. Hepatology, 46, 140-146. doi:10.1002/hep.21684
[7] Katabathina, V.S., Menias, C.O., Shanbhogue, A.K.P., Fagirdar, F., Paspulati, R.M. and Prasad, S.R. (2011) Genetics and imaging of hepatocellular adenomas: 2011 update. AbdGast Imaging, 31, 1529-1543.
[8] Laumonier, H., Cailliez, H., Balabaud, C., Possenti, L., Zucman-Rossi, J., Bioulac-Sage, P. and Trillaud, H. (2012) Role of contrast-enhanced sonography in differentiation of subtypes of hepatocellular adenoma: Correlation with MRI findings. American Journal of Roentgenology, 199, 341-348. doi:10.2214/AJR.11.7046
[9] Pliati, C., Amessou, M., Bihl, M.P., Balabaud, C., Nhieu, J.T., Paradis, V., Nault, J.C., Izard, T., Bioulac-Sage, P., Couchy, G., et al. (2011) Somatic mutations activating STAT3 in human inflammatory hepatocellular adenomas. Journal of Experimental Medicine, 208, 1359-1366. doi:10.1084/jem.20110283
[10] Dokmak, S., Paradis, V., Vilgrain, V., Sauvanet, A., Farges, O., Valla, D., Bedossa, P. and Belghiti, J. (2009) A single-center surgical experience of 122 patients with single and multiple hepatocellular adenomas. Gastroenterology, 137, 1698-1705. doi:10.1053/j.gastro.2009.07.061
[11] Stoot, J.K., van de Linden, E., Terpstra, O.T. and Schaapherder, A.F. (2007) Life-saving therapy for haemorrhaging liver adenomas using selective arterial embolization. British Journal of Surgery, 94, 1249-1253. doi:10.1002/bjs.5779

comments powered by Disqus

Copyright © 2020 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.