Adult hepatic cavernous haemangioma with highly elevated alpha-fetoprotein

A 35-year-old Chinese man presented with dull pain in the right hypochondrial region for the previous 2 months. Laboratory examination revealed that his serum alpha-fetoprotein level was 1890 microg/L (reference range, 0-20 microg/L), and computed tomographic scan showed a hypodense lesion in the left liver lobe. At laparotomy, a dark reddish soft tumour (3.0 x 3.5 cm in diameter) was found in the medial segment of the liver (segment III). The tumour became markedly smaller than that before resection, and a vessel-like structure was found on the cut surface. Intra-operative pathology and postoperative histopathology examinations revealed that the tumour was a cavernous haemangioma of the liver. The serum alpha-fetoprotein level decreased to 3.5 microg/L by the fourth postoperative week. Clinicians should be aware that some rare tumours besides hepatocellular carcinoma and endodermal sinus tumours (yolk sac tumour), for example, hepatic haemangioma, can produce alpha-fetoprotein.