A Case of Hepatocellular Adenoma with Elevated Serum PIVKA-II Level Presented with Right Lower Abdominal Pain.

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  • ＰＩＶＫＡ‐ＩＩ上昇を伴い右下腹部痛で発症した肝細胞腺腫の１例

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Abstract

A 24-year-old man, who had no predisposing factors, presented with a sudden onset of abdominal pain in the right lower quadrant (PLQ). An echography showed a large mass occupying the right lobe of the liver. An abdominal CT scan revealed a large hepatic tumor with an expansive growth to the RLQ. Celiac angiography showed a large hypervascular lesion. An angio-CT showed a hypervascular tumor containing a number of nodular high-density areas concomitant with a low-density area. It also demonstrated that enlarged arteries surrounding the tumor supplied centripetal small branches, compatible with hepatocellular adenoma (HCA). Serum PIVKA-II level was as high as 5, 700mAU/ml, which decreased to the normal level after resection. He underwent right lobectomy of the liver. The specimen revealed a 21×9×8cm, tan, ovoid mass, which had arisen in the nomal liver. Final pathologic diagnosis was HCA. This unusual case of HCA with a high PIVKA-II level presenting with an acute RLQ pain is presented.

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