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5 2) Edmondson HA: Differential diagnosis of tumors and tumor-like lesions of the liver in infancy and children. Am J Dis Child 91: , ) Creig JR, Peters RL, Edmondson HA, et al: Fibrolamellar of adolescents carcinoma of the liver: A tumor and young adults with distinc tive clinico-pathologic features. Cancer 46: , ) Titlbaum DS, Hatabu H, Schiebler ML, et al: Fibrolamellar hepatocellular carcinoma; MR appearance. J Comput Assist Tomogr 12: , ) Rummeny E, Weissleder R, Sironi S, et al: Central scars in primary liver tumors; MR features, specificity, and pathologic correra tion. Radiology 171: , ) Ichikawa T, Federle MP, Grazioli L, et al: Hepatocellular adenoma; Multiple CT and histopathological findings in 25 patients. Radi ology 214: , ) Ichikawa T, Federle MP, Grazioli L, et al: Fibrolamellar hepatocellular carcinoma: Imag ing and pathologic findings in 31 recent cases. Radiology 213: , ) Paradinas FJ, Melia WM, Wilkinson ML, et al: High serum vitamin B12 binding capacity as a marker of the fibrolamellar variant of he patocellular carcinoma. Br Med J 285: , ) Collier NA, Weinbren K. Bloom SR, et al: Neurotensin secretion by fibrolamellar car cinoma of the liver. Lancet 1: , ) Soyer P, Roche A, Levesque M, et al: CT of fibrolamellar hepatocellular carcinoma. J Cpmput Assist Tomogr 15: , ) Ichikawa T, Federle MP, Grazioli L, et al: Fibrolamellar hepatocellular carcinoma: Pre and posttherapy evaluation with CT and MR imaging. Radiology 217: , ) Berman M, Libbey NP, Foster JH: Hepatocel lular carcinoma. Polygonal cell type with fibrous stroma-an atypical variant with a favorable prognosis. Cancer 46: , ) Nagorney DM, Adson MA, Weiland LH, et al: Fibrolamellar hepatoma. Am J Surg 149: , ) Ringe B, Wittekind C, Weimann A: Results of hepatic resection and transplantation for fi brolamellar carcinoma. Surg Gynecol Obstet 175: , ) El-gazzaz G, Wong W, El-hadary MK, et al: Outcome of liver resection and transplantation for fibrolamellar hepatocellular carcinoma. Transpl Int 13: , 2000

6 A RESECTED CASE OF FIBROLAMELLAR HEPATOCELLULAR CARCINOMA Jun HASEGAWA, Yukio TAKANO, Nobuyuki MUSHA, Shintaro KOMUKAI, Kazuyoshi SUDA, Kanako FUJITA and Ken SAITOU* Department of Surgery and Department of Pathology*, Akita Red Cross Hospital We reported a case of a 48-year-old man with fibrolamellar hepatocellular carcinoma (FLHCC), which is rare in Japan. The patient was referred to us due to hepatic tumor which was found with liver dysfunction at a medical checkup. HBs-antigen and HCV-antibody were negatie. Both the serum AFP and the PIVKA-II were elevated. The tumor was about 4cm in diameter in the posterior segment of liver on ultrasonograpy (US). Abdominal plain CT scan showed a low-density tumor, and dynamic CT showed a heterogeneous enhancement with gradual enhancement from the peripheral region. Angiography revealed hypovascularity. Ultrasound-guided fine needle biopsy confirmed the presence of FLHCC, and right hepatectomy was performed. FLHCC is an uncommon variant of HCC occurring in young and usually non-cirrhotic livers, and has a better prognosis than other hepatocellular carcinomas.

40: 127-130, 1994 11) Damjanov I, Moriber K, Catalano E, et al: Myelolipoma in a heterotopic adrenal gland. Light and electron microscopic findings. Can cer 44: 1350-1356, 1979 12) DeNavasquez S: Case

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