Treatment of a non-typical hepatic pseudolesion complicated by greatly elevated alpha fetoprotein: case report and literature review

World Journal of Surgical Oncology

Hai-Yan Cui²  Li-Xin Liu³  Qing-Zhu Wei¹  Yong-Hong Liang⁴  Fu-Qiang Li⁵  Ling-Yan Zhang⁴  Xiao-Long Liu³ 

[1] Department of Pathology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, PR China;Department of Internal Medicine, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, PR China;Department of General Surgery, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, PR China;Department of Radiology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, PR China;Department of General Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, PR China

关键词: Diagnosis;    Alpha fetoprotein;    Hepatic pseudolesion;   

Others  :  821783
DOI  :  10.1186/1477-7819-11-238

 received in 2013-02-26, accepted in 2013-09-11,  发布年份 2013

【 摘 要 】

Background

Hepatic pseudolesions detected by helical computed tomography (CT) are not rare, but it is difficult to make a final diagnosis when the hepatic lesion is complicated by the presence of greatly elevated alpha fetoprotein (AFP). Clinical treatment of non-typical hepatic pseudolesions complicated by greatly elevated AFP should confirm the diagnosis and minimize trauma.

Case presentation

Non-invasive procedures including ultrasonography, CT, and micro-invasive digital subtraction angiography could not safely differentiate this lesion from a malignant focus when it was complicated by greatly elevated AFP. Laparoscopic hepatectomy was performed, and pathological analysis showed chronic hepatitis, nodular regenerative hyperplasia, focal nodular hyperplasia of the liver, and mild vascular malformation. The tissue was HbsAg(−), HbcAg(−), and AFP(+).

Conclusion

Heightened awareness of hepatic pseudolesion complicated by primarily elevated AFP will help physicians avoid unnecessary invasive procedures. Hepatic biopsy is inevitable because of greatly elevated AFP. For suspected hepatic pseudolesion with elevated AFP, needle-core biopsy and follow-up surveillance instead of hepatectomy are recommended to find the source of AFP and make a final diagnosis of pseudolesion.

【 授权许可】

   
2013 Liu et al.; licensee BioMed Central Ltd.

【 图 表 】

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