[Atypical variant of a hepatocellular carcinoma with a favourable course (author's transl)]

The case of a 51 years old man with a hepatocellular carcinoma (HCC) is reported. Though the tumor is of multifocal origin and widespread the disease takes a favourable course. Histology revealed a well differentiated HCC with clusters of polygonal tumor cells and fibrous stroma, the pattern of which reminds of focal nodular hyperplasia (FNH). HCC has developed in a non cirrhotic liver. Clinically, the patient is in a good condition 22 months after diagnosis of the tumor. The value of all possible methods--invasive and not invasive--for diagnosis of HCC is assessed and compared with literature. According to the literature the survival time comes to 3 to 6 months on average, only single cases take a more favourable course. Correlation of morphology and biological behaviour of tumor is lacking. In our case the pattern of fibrosis similar to FNH is striking and points to a development of carcinoma in preexisting FNH. In literature, however, evidence for a malignant transformation of FNH is lacking.