Adult hepatic cavernous hemangioma with highly elevated α-fetoprotein: A case report and review of the literature

Abstract

A 47-year-old male presented with a six-month history of fatigue and a four-month history of alanine and aspartate aminopherase elevation. Laboratory examination revealed that the serum α-fetoprotein (AFP) level was 371.51 μg/l (normal range, 0-20 μg/l), and a computed tomography scan revealed a hypodense lesion in the left hepatic lobe. During laparotomy, a dark red-colored soft tumor (1.5×1.7 cm in diameter) was found in segment eight of the liver. Intra-operative pathology and post-operative histopathology examinations revealed that the tumor was a hepatic cavernous hemangioma. The serum AFP level was decreased to 24.45 μg/l by the second post-operative week. The literature was searched and only three similar cases were found. A brief review of this rare disease entity was produced, which attempted to explain this appearance reasonably.

Keywords: cancer stem cell; hepatic cavernous hemangioma; α-fetoprotein.

Figure 1

Computed tomography scans revealing (A) a 1.3-cm well-defined tumor in segment eight of the liver. The tumor presents (B) punctate enhancement in the early phase while (C) the enhancement becomes stronger in the delayed phase.

Figure 2

Positron emission tomography revealing a tumor (arrow) of low intensity with a mildly active metabolism in segment eight of the liver.

Figure 3

Histopathology examinations revealing that the tumor was a cavernous hemangioma of the liver (hematoxylin and eosin stain; magnification, ×40).