A Case of Fibrolamellar Hepatocellular Carcinoma at the High Specialty Hospital of Veracruz, Mexico

Abstract

Fibrolamellar hepatocellular carcinoma is a primary hepatic malignancy, primarily affecting adolescents and young adults without underlying liver disease. We present the case of a 22-year-old male farmer who presents burning pain in the epigastrium with an intensity of 2/10 on the VAS scale, on palpation with the presence of a tumor in the right hypochondrium with ultrasound of the liver and bile ducts with evidence of liver mass in the segment VIII, in addition to exploratory laparoscopy with the discovery of multiple implants in 70% of the liver surface. In the histopathological analysis with morphological findings compatible with fibrolamellar carcinoma. In the laboratory with AST 356 UI/L, ALT 205 UI/L, GGT 930 U/L, LDH 343 UI/L AF 638 UI/L, for which treatment was started with atezolizumab 1200 mg and bevacizumab 1000 mg. Continuing to follow up. Fibrolamellar hepatocellular carcinoma is a variant of hepatocellular carcinoma, which usually presents with non-specific symptoms. The imaging approach is fundamental in the diagnosis, being the anatomopathological confirmation. Despite being low frequency tumors, they should be suspected in all young patients with a palpable mass in the liver.