Fibrolamellar hepatocellular carcinoma

Case contributed by Dr Ian Bickle


A teenager presents with a palpable right upper quadrant mass. No past medical history.

Patient Data

Age: 15 years
Gender: Male

Huge heterogeneous enhancing mass involving segments 4 and 5 of the liver.

No capsule extension. 

Case Discussion

Fibrolamellar hepatocellular carcinoma is a distinct variant of generic hepatocellular carcinoma.

The 5 distinct aspects compared to generic HCC are:

  • young age at presentation -  young adults (15 to 40 years of age)
  • no association with cirrhosis
  • usually large at presentation
  • not associated with raises serum alpha feto protein
  • less aggressive with a better 5-year survival

On cross sectional imaging the tumor is usually large, heterogeneous, enhances most in the arterial phase and may have a central 'scar' like component.

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Case information

rID: 32543
Published: 5th Dec 2014
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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