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JPTM > Ahead-of Print

doi: https://doi.org/10.4132/jptm.2017.11.12    [Epub ahead of print]
Hepatocellular Carcinoma Arising in a Huge Hepatocellular Adenoma with Bone Marrow Metaplasia
Hyo Jeong Kang1,2, Hui Jeong Jeong1, So-Woon Kim1, Eunsil Yu1,3, Young-Joo Lee4, So Yeon Kim5, Jihun Kim1
1Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
2Department of Physiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
3Department of Asan Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
4Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
5Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Corresponding Author: Jihun Kim ,Tel: +82 2 3010 4556, Fax: +82 2 472 7898, Email: Jihunkim@amc.seoul.kr
Received: September 8, 2017;  Revised: October 30, 2017  Accepted: November 12, 2017.  Published online: December 27, 2017.
ABSTRACT
Hepatocellular adenoma (HCA) is the most common type of benign liver tumor, and its major complication is malignant transformation to hepatocellular carcinoma (HCC). Here, we report a case of HCC arising in HCA with bone marrow metaplasia in a 24-year-old Korean woman who presented with abdominal discomfort. A huge liver mass was found on abdominal ultrasonography. She underwent surgical hepatic resection, and the resected specimen was entirely involved by a 20 cm sized tumor. Histological review revealed a well differentiated HCC arising from inflammatory HCA with β-catenin nuclear positivity and bone marrow metaplasia that contained hematopoietic cells. This case was unique because malignant transformation, inflammatory type HCA, β-catenin nuclear staining, and bone marrow metaplasia were simultaneously observed. Additionally, it should be noted that a large HCA with β-catenin activation can undergo malignant transformation and should be surgically resected in a timely manner.
Key Words: hepatocellular carcinoma, hepatocellular adenoma, bone marrow metaplasia, β-catenin