Long-term surviving patients with hepatocellular carcinoma comprised of dense collagenous stroma

In two patients with hepatocellular carcinoma (HCC), treated surgically, we observed a dense collagenous stroma not heretofore reported. Grossly, the tumors consisted of a broad area of dense collagenous stroma that embedded the nodules of the HCC. Microscopically, nodules of the cancer cells were widely separated by this dense fibrous stroma, in association with surrounding inflammatory infiltrates, composed mainly of lymphocytes. These two patients had lived, respectively, for 10 yr and 2 months, and 8 yr and 9 months, despite precarious clinical states. HCC with characteristics such as a grossly distinct dense collagenous stroma and an inflammatory infiltrate may relate to a distinct category with a favorable prognosis.