Ｃ型肝炎に発生した成人肝芽腫の１切除例

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  • A Successfully Resected Case of Adult Hepatoblastoma with Hepatitis C

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We reported a rare case of adult hepatoblastoma in a 54-year-old man with hepatitis C who was found to have a liver tumor in segment 6 during a medical checkup. AFP was elevated to 301ng/ml and the AFP-L3 ratio was 72.5%. Abdominal ultrasound showed a mixed-echo tumor. Abdominal CT showed a low-density area with unclear border. After administration of contrast medium, the tumor was partially enhanced in the early phase without washout in late phase. Systematic posterior segmentectomy was successful. The tumor was 3 cm in diameter and was the smallest adult hepatoblastoma known, to the best of our knowledge. HE staining showed a fibrous capsule and septum, with some foci of hemorrhage, necrosis, and fibrosis in the tumor. Embryonal epithelial cells with hyperchromatic nuclei had proliferated irregularly. Osteoid-like and cartilaginous foci, myxomatous stroma, and tumor cells multiplied in a trabecular pattern similar to hepatocellular carcinoma were observed. Pathological examination showed mixed epithelial and mesenchymal hepatoblastoma. The background liver was assessed as F3-F4 instaging of fibrosis and A2 in grading of inflammation. The patient was definitively diagnosed with Stage III based on staging criteria of primary liver cancer in Japan. Adjuvant hepatic arterial chemotherapy with cisplatin and farmorubicin was done, and the patient has been well and free of recurrence for about two years, with tumor markers remaining normal.

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