Abstract
BackgroundHepatocellular adenoma (HCA) subtypes are considered as risk factors for malignant transformation; thus, an accurate diagnosis is important. We report a case of resected HCA previously diagnosed as unclassified HCA using immunohistochemistry, subsequently discovered to harbor a mutation in exon 3 of the beta (β)-catenin gene using deoxyribonucleic acid (DNA) sequencing.Case presentationThe patient was a 26-year-old woman who was referred to our hospital because of a 150-mm tumor in the right lobe of the liver. Considering the possibility of malignancy, we performed right lobe hepatectomy. Based on the histopathological and immunohistochemical findings, the tumor was diagnosed as an unclassified HCA. Next, we performed sequencing of DNA isolated from the tumor and identified a mutation in exon 3 of β-catenin, suggesting that the tumor contained an activating mutation of the β-catenin gene.Conclusionβ-Catenin mutations in HCA cannot be detected by immunohistochemistry alone, and molecular analysis is required to accurately diagnose and evaluate its prognosis.
Highlights
Hepatocellular adenoma (HCA) subtypes are considered as risk factors for malignant transformation; an accurate diagnosis is important
HCA is divided into four subtypes based on molecular and pathological features: hepatocyte nuclear factor 1 alpha (HNF1α)-mutated HCA (HHCA), inflammatory HCA (IHCA), β-catenin-mutated HCA (b-HCA), and unclassified HCA (UHCA) [2]
Immunohistochemical analysis usually shows a lack of liver fatty acid-binding protein (LFABP) in Hepatocyte nuclear factor alphamutated HCA (HHCA), serum amyloid A (SAA) and C-reactive protein (CRP) overexpression in IHCA, diffuse and strong glutamine synthetase (GS)
Summary
Hepatocellular adenoma (HCA) subtypes are considered as risk factors for malignant transformation; an accurate diagnosis is important. Conclusion: β-Catenin mutations in HCA cannot be detected by immunohistochemistry alone, and molecular analysis is required to accurately diagnose and evaluate its prognosis. *Correspondence: nharimotoh1@gunma‐u.ac.jp 1 Department of General Surgical Science, Division of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, 22 Showa‐Machi, Maebashi, Gunma 371‐8511, Japan Full list of author information is available at the end of the article expression and nuclear β-catenin in b-HCA, and no specific features in UHCA [3].
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