Hepatocellular pseudotumor in the cirrhotic liver. Report of three cases

Three cases of regenerating hyperplastic nodule in the cirrhotic liver are reported in detail. The patients were all men, ranging in age from 41 to 57 years. They were all heavy drinkers and had chronic liver disease for 6 to 10 years. All patients had slightly elevated alpha-fetoprotein levels and were positive for HBs and HBc antibodies. Radiologic findings were not uniform except for ultrasonography, which demonstrated the lesion in all cases. Preoperative diagnosis was hepatocellular carcinoma (HCC) or highly suspicious of HCC in all of them. At laparotomy, all lesions were embedded in the liver parenchyma and invisible from the hepatic surface. With the aid of intraoperative sonography, partial hepatic resections were performed. Pseudocapsule was seen in two cases. Definitive differential diagnosis of regenerating nodules from HCC in the cirrhotic liver was extremely difficult. The authors propose the name "hepatocellular pseudotumor in the cirrhotic liver" to describe such lesions.