完全内臓逆位症の正常肝に発生した肝細胞癌の１切除例

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  • HEPATOCELLULAR CARCINOMA WITH SITUS INVERSUS TOTALIS, DEVELOPED IN NON-CIRRHOTIC LIVER-A CASE REPORT-

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A 76-year-old man saw a local medical doctor because of a sense of fullness in his upper abdomen. Tumor-like resistance and tenderness were recognized in his left hypochondrium and epigastrium, and he was referred to our hospital under suspicion of pylorus stenosis. Plain chest X-ray revealed dextrocardia, and plain CT revealed that all his abdominal organs were placed inversely. He was diagnosed with situs inversus totalis. Moreover, a large liver tumor was recognized in the right lobe which was located in the patient's left side. According to laboratory tests, both HBs Ag and HCV Ab were negative, but the serum level of AFP and PIVKA-II elevated. Angiography revealed tumor stain in right lobe, and this tumor was diagnosed as hepatocellular carcinoma. No aberrant vessels were detected. After TAE (transcatheter arterial embolization), hepatic right trisegmentectomy was performed. Microscopically, the tumor was diagnosed as a poorly-differentiated hepatocellular carcinoma appearing in the normal liver. We report this case with some bibliographical comments.

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