Presentation
A teenager presents with a palpable right upper quadrant mass. No past medical history.
Patient Data
Age: 15 years
Gender: Male
From the case:
Fibrolamellar hepatocellular carcinoma
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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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