A Case of Huge Hepatocellular Adenoma with an Elevated Serum PIVKA-II Level Treated with Hepatectomy

Takahashi Naoki, Kamiyama Toshiya, Orimo Tatsuya, Shimada Shingo, Nagatsu Akihisa, Kamachi Hirofumi, Mitsuhashi Tomoko, Taketomi Akinobu

doi:10.5833/jjgs.2020.0055

<p>The patient was an 18-year-old man with a high γ-GTP level and a huge tumor found in the lateral segment of the liver on abdominal US. He was admitted to our hospital. Dynamic CT showed a tumor of 18 cm in diameter in the left lateral segment. The tumor was strongly enhanced in the arterial phase and showed prolonged enhancement in the delayed phase. In addition, PIVKA-II was elevated to 481 mAU/ml. The diagnosis was suspected hepatocellular adenoma (HCA), but the possibility of hepatocellular carcinoma could not be ruled out. Given the risk of rupture, we decided to perform hepatectomy and we ultimately performed left hemihepatectomy. The tumor was finally diagnosed as inflammatory type of HCA (CD34 (+), serum-amyloid-A (+), β-catenin (−), liver fatty acid-binding protein (−)) by immunohistochemistry examination. The postoperative course was uneventful and the patient was discharged 7 days after surgery. HCA may be an appropriate differential diagnosis for a huge liver mass in a young patient, and surgical resection should be considered for diagnosis and treatment.</p>

A Case of Huge Hepatocellular Adenoma with an Elevated Serum PIVKA-II Level Treated with Hepatectomy

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