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Case Reports in Pathology
Volume 2015 (2015), Article ID 609780, 5 pages
http://dx.doi.org/10.1155/2015/609780
Case Report

Hepatocellular Carcinoma with Both Fibrolamellar and Classical Components: An Unusual Morphological Pattern

1Department of Pathology and Laboratories, Hospital Universitario Fundación Santa Fe de Bogotá, Calle 119 No. 7–75, Bogotá 110111, Colombia
2School of Medicine, University of Los Andes, Carrera 1 No. 18A-12, Bogotá 111711, Colombia
3Department of Pathology, Good Samaritan Regional Medical Center, 255 Lafayette Avenue, Suffern, NY 10901, USA
4Transplant and Hepatobiliary Surgical Service, Hospital Universitario Fundación Santa Fe de Bogotá, Calle 119 No. 7–75, Bogotá 110111, Colombia
5School of Medicine, National University of Colombia, Carrera 45 No. 26-85, Bogotá 111711, Colombia

Received 8 October 2014; Revised 3 February 2015; Accepted 18 February 2015

Academic Editor: Hiroko Kuwabara

Copyright © 2015 Diana Castro-Villabón et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Fibrolamellar carcinoma (FLC) is an uncommon form of primary liver malignancy with unique clinical, histological, and biological characteristics. It is usually seen in young adults without underlying liver disease. Histologically, it shows large cells with abundant eosinophilic cytoplasm, large vesicular nuclei, prominent nucleoli, and lamellar type fibrosis. In contrast, classical hepatocellular carcinoma (HCC) is typically present in elderly male patients with cirrhosis. It is the most common histological subtype, and it is characterized by its resemblance to the normal liver, both in its growth pattern and its cytology. The unusual case of a liver carcinoma that presented with histological features of both FLC and classical HCC is herein reported. This was the case of a 37-year-old female complaining of diffuse abdominal discomfort and epigastric pain for two months. She was referred to us for further management after she was diagnosed with HCC in a noncirrhotic liver. She underwent a left-sided hepatectomy. A yellow nodular mass with well-defined borders and a necrotic center was present in the resection specimen. The morphological features and immunohistochemical studies were consistent with a diagnosis of FLC mixed with classical HCC. The patient was followed up for five months, and no signs of recurrence were evident.