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Updated: Jun 18, 2026
07:43
Laparoscopic S7 Hepatectomy with Positive Fluorescence Staining
Published on: May 9, 2025
[A case of ectopic hepatocellular carcinoma]
Shin-ichiro Fukuda1, Koji Yano, Kazuyuki Ohata
1Department of Gastroenterology and Hepatology, National Hospital Organization Nagasaki Medical Center, Japan.
Summary
A 47-year-old woman had elevated alpha fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) levels. Imaging revealed a tumor, later diagnosed as hepatocellular carcinoma, distinct from the liver.
Area of Science:
- Hepatology
- Oncology
- Diagnostic Imaging
Background:
- Elevated tumor markers, alpha fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP), can indicate liver disease.
- Hepatocellular carcinoma (HCC) is a primary liver cancer often associated with chronic viral hepatitis.
Observation:
- A 47-year-old woman presented with elevated AFP and DCP, but negative viral hepatitis markers.
- Initial abdominal CT was unremarkable; however, MRI and repeat CT identified a 20mm tumor near the inferior vena cava and liver.
- The tumor was surgically resected and found to be adjacent to, but distinct from, the liver parenchyma.
Findings:
- Histological examination confirmed moderately differentiated hepatocellular carcinoma.
- Tumor cells showed positive staining for hepatocyte-specific antigen and AFP, consistent with HCC origin.
- The tumor capsule was connected to the liver but anatomically separate from hepatic, renal, and adrenal tissues.
Implications:
- This case highlights the importance of advanced imaging in diagnosing liver tumors when initial screening is negative.
- Elevated AFP and DCP can be crucial diagnostic markers for hepatocellular carcinoma, even in the absence of viral hepatitis.
- The distinct anatomical location of the tumor provides insights into the potential origins and presentation of hepatocellular carcinoma.
