A rare presentation of hepatocellular carcinoma in non-cirrhotic liver

Lamia Kabbage,Nawal Kabbaj,Meryem Elkouhen,Kaoutar Znati,Ahmed Taghy

doi:10.11604/pamj.2017.28.69.13512

Abstract

Hepatocellular carcinoma is the most frequent type of liver malignancy. Most cases of hepatocellular carcinoma are secondary to either viral hepatitis (hepatitis B, C) or alcoholic cirrhosis. Liver cirrhosis due to any other causes is considered as a risk factor for development of hepatocellular carcinoma; however, hepatocellular carcinoma in non cirrhotic livers remains a rare condition. The present case report describes a 59-year-old woman patient admitted to explore right hypochondriac and epigastric pain, with no evidence of pre-existing liver disease and with a good general condition. The computed tomography was very suggestive of a gastro-intestinal stromal tumor. But, at laparotomy, a huge hepatic tumor was discovered. Histopathological study confirmed the presence of primary hepatocellular carcinoma. Hepatocellular carcinoma occurs more frequently on a cirrhotic liver. However, it can occur on a non cirrhotic liver and remains and extremely rare case.

Highlights

The incidence of hepatocellular carcinoma (HCC) is constantly rising throughout the world with the majority of cases in Asia and Africa due to the high prevalence of hepatitis B virus (HBV) infection [1]
HCC is the most frequent type of primary malignant lesion of the liver, the sixth leading cause of cancer and the third leading cause of cancer death [2]. It develops on cirrhotic liver in 80% of cases, appearing in a 20% on healthy livers or with non-cirrhotic chronic liver disease [3]
We report a case of an HCC on a healthy liver diagnosed initially as a gastro-intestinal stromal tumor (GIST)

Summary

Introduction

The incidence of hepatocellular carcinoma (HCC) is constantly rising throughout the world with the majority of cases in Asia and Africa due to the high prevalence of hepatitis B virus (HBV) infection [1]. HCC is the most frequent type of primary malignant lesion of the liver, the sixth leading cause of cancer and the third leading cause of cancer death [2] It develops on cirrhotic liver in 80% of cases, appearing in a 20% on healthy livers (fibrolamellar variant) or with non-cirrhotic chronic liver disease [3]. The abdominal examination revealed an enormous and firm mass of the right hypochondriac that reaches the right iliac fosse, no splenomegaly or ascites She had no peripherical stigmata of chronic liver disease. An abdominal computed tomography (CT) revealed a tissular lesion of 151 x 108 x 82 mm with heterogeneous enhancement, located in the right flank having an intimate contact with the gastric antrum (Figure 2) It develops towards the hepatic hilus and compresses the biliay convergence inducing a slight intrahepatic bile ducts dilatation. By lack of means, our patient could not have the chemotherapy by Sorafenib and she died after 5 months of HCC diagnosis

Discussion

Findings

Conclusion