Abstract
The patient was a 59-year-old man without any particular complaint. Upon examination, he was found to have a high serum CEA level, and a subsequent detailed examination revealed a hepatic tumor in the medial segment of the left hepatic lobe (S4). The tumor was suspected of being metastatic because his serum AFP level was within normal range. Detailed examination of other intra-abdominal organs, however, revealed no abnormalities. Therefore, after diagnosis of a primary hepatic carcinoma producing CEA, the S4 subsegment was excised using the microwave coagulator. The tumor size was 2.6×1.8cm. Histopathologically, it was found to be a hepatocellular carcinoma of Edmondson type II with a capsule. The postoperative course has been favorable; the serum CEA level returned to normal, thereby confirming the production of CEA by the tumor. Increased CEA levels are rare in primary hepatocellular carcinomas, but very common in metastatic liver cancers. Therefore, detailed examination of other intra-adbominal organs is necessary in the diagnosis of such cases.
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