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2) Edmondson HA: Differential diagnosis of tumors and tumor-like lesions of the liver in infancy and children. Am J Dis Child 91: 168-186, 1956 3) 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: 372-379, 1980 11) Titlbaum DS, Hatabu H, Schiebler ML, et al: Fibrolamellar hepatocellular carcinoma; MR appearance. J Comput Assist Tomogr 12: 588-591, 1988 12) Rummeny E, Weissleder R, Sironi S, et al: Central scars in primary liver tumors; MR features, specificity, and pathologic correra tion. Radiology 171: 323-326, 1989 13) Ichikawa T, Federle MP, Grazioli L, et al: Hepatocellular adenoma; Multiple CT and histopathological findings in 25 patients. Radi ology 214: 861-868, 2000 14) Ichikawa T, Federle MP, Grazioli L, et al: Fibrolamellar hepatocellular carcinoma: Imag ing and pathologic findings in 31 recent cases. Radiology 213: 352-361, 1999 7) 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: 840-842, 19828 ) Collier NA, Weinbren K. Bloom SR, et al: Neurotensin secretion by fibrolamellar car cinoma of the liver. Lancet 1: 538-540, 1984 9) Soyer P, Roche A, Levesque M, et al: CT of fibrolamellar hepatocellular carcinoma. J Cpmput Assist Tomogr 15: 533-538, 1991 10) Ichikawa T, Federle MP, Grazioli L, et al: Fibrolamellar hepatocellular carcinoma: Pre and posttherapy evaluation with CT and MR imaging. Radiology 217: 145-151, 2000 16) Berman M, Libbey NP, Foster JH: Hepatocel lular carcinoma. Polygonal cell type with fibrous stroma-an atypical variant with a favorable prognosis. Cancer 46: 1448-1455, 1980 17) Nagorney DM, Adson MA, Weiland LH, et al: Fibrolamellar hepatoma. Am J Surg 149: 113-119, 1984 18) Ringe B, Wittekind C, Weimann A: Results of hepatic resection and transplantation for fi brolamellar carcinoma. Surg Gynecol Obstet 175: 299-305, 1992 19) El-gazzaz G, Wong W, El-hadary MK, et al: Outcome of liver resection and transplantation for fibrolamellar hepatocellular carcinoma. Transpl Int 13: 406-409, 2000

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.