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Voluminous fibrolamellar carcinoma in a young adult: A case report
Aziz Atallah1, Sana Ben Slama2, Mohamed Guelbi1
1Department of Surgery, Mongi Slim Hospital, Marsa, Tunisia.
Introduction:
Fibrolamellar carcinoma (FLC) is a rare primary liver cancer, typically presenting as a solitary nodule in young adults without underlying liver disease. Surgical resection is currently the only curative treatment.
Presentation Of Case:
We report a 27-year-old woman with a 6-month history of moderate epigastric pain, right upper quadrant heaviness, and a 20-kg weight loss. Imaging studies (ultrasound, CT, and MRI) revealed an 11-cm mass in the right liver featuring a central scar and calcifications, highly suggestive of FLC. A liver biopsy confirmed the diagnosis. The patient subsequently underwent a right hepatectomy with en bloc resection of an adherent diaphragmatic collar and lymphadenectomy. Her postoperative course was uneventful, leading to discharge on postoperative day 10.
Discussion:
FLC accounts for less than 1 % of primary liver tumors and is distinct from conventional hepatocellular carcinoma, primarily due to its occurrence in non-cirrhotic, younger patients. Characteristic radiologic findings include a well-circumscribed, large lesion with a central fibrous scar and occasional calcifications. Although the prognosis post-resection is generally favorable, recurrence rates exceed 60 %, emphasizing the need for aggressive surgical management and vigilant long-term follow-up.
Conclusion:
FLC is a distinct clinical entity with improved surgical outcomes compared to classical hepatocellular carcinoma. Nonetheless, its high recurrence potential necessitates continued surveillance and further research to optimize treatment strategies.
