Clinical Medical Image Library Clin Med Img Lib 10.23937/2474-3682 2474-3682 ClinMed International Library Wilmington, USA 10.23937 Fibrolamellar Hepatocellular Carcinoma Mu S 10.23937/2474-3682/1510219 A 38-year-old man with past medical history of epilepsy presented to the emergency room complaining of 1 day of abdominal pain without nausea or vomiting. He had similar symptoms 4 months ago that resolved spontaneously. CLINICAL IMAGE 9 2 OPEN ACCESS 10.23937/2474-3682/1510219 Fibrolamellar Hepatocellular Carcinoma Scott Mu Department of Surgery, Rutgers New Jersey Medical School, Newark NJ, USA William Spataro Department of Pathology, Immunology, and Laboratory, Rutgers New Jersey Medical School, Newark NJ, USA Ravi Chokshi Department of Surgery, Rutgers New Jersey Medical School, Newark NJ, USA Scott Mu
MD, MHS, General Surgery Resident, Rutgers New Jersey Medical School, Newark NJ, USA.
18 June 2023 Mu S, Spataro W, Chokshi R 2023 Fibrolamellar Hepatocellular Carcinoma Clin Med Img Lib 10.23937/2474-3682/1510219 2023 Mu S, et al. © This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

A 38-year-old man with past medical history of epilepsy presented to the emergency room complaining of 1 day of abdominal pain without nausea or vomiting. He had similar symptoms 4 months ago that resolved spontaneously.

He denied previous alcohol or tobacco use, and his serum alpha fetoprotein level was normal at 3.8 ng/mL. Computed tomography (CT) imaging of his abdomen and pelvis demonstrated a 10.4 cm mass in the right liver with heterogeneous areas of mixed high and low attenuation (Figure 1A).

Core needle biopsy demonstrated numerous dyshesive malignant cells with enlarged nuclei, prominent nucleoli, and oncocytic cytoplasm with intracytoplasmic lumens and granules.

He underwent right hepatectomy and pathological examination demonstrated a solitary 10.5 × 10.1 × 7.0 cm fibrolamellar hepatocellular carcinoma with negative margins (Figure 1B and Figure 1C).

He recovered uneventfully and was doing well at his follow-up appointment 1 week after discharge.

None of the authors have any conflicts of interest to disclose.

Figure 1: Liver cancer. (A) Computed tomography (CT) imaging of his abdomen and pelvis demonstrated a 10.4 cm mass in the right liver with heterogeneous areas of mixed high and low attenuation (Panel A); (B and C) Right hepatectomy and pathological examination demonstrated a solitary 10.5 × 10.1 × 7.0 cm fibrolamellar hepatocellular carcinoma with negative margins (Panel B, Panel C).