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Case Reports
. 2020 Nov;27(6):429-433.
doi: 10.1159/000507201. Epub 2020 Apr 15.

Fibrolamellar Carcinoma: A Multimodal Approach

João Vasco Barreira  1 , Nádia Silva  2 , Anuraj Parmanande  1 , Manuel Rocha  3 , João S Coelho  2 , Hugo Pinto Marques  2 , Ricardo da Luz  1
Affiliations
Case Reports

Fibrolamellar Carcinoma: A Multimodal Approach

João Vasco Barreira et al. GE Port J Gastroenterol. 2020 Nov.

Abstract
in English, Portuguese

Fibrolamellar carcinoma is a rare variant of hepatocellular carcinoma not associated with cirrhosis or viral hepatitis. Serum alpha-fetoprotein levels are usually normal; the histology is of a well-differentiated tumor, and the staging is the same as for hepatocellular carcinoma. We describe the case of a female patient in her 4th decade of life with a diagnosis of fibrolamellar hepatocellular carcinoma with a multimodal approach. The rare incidence of this cancer and its unusual clinical presentation justifies reporting this case and highlights the importance of multidisciplinary teams in the treatment of cancer patients.

O Carcinoma fibrolamelar é uma variante rara de hepatocarcinoma, não associado a cirrose ou hepatites virais. Os níveis séricos de alfafetoproteína são geralmente normais; A histologia é de um tumor bem diferenciado e o estadiamento é o mesmo do hepatocarcinoma. Descrevese o caso clínico de um doente do sexo feminino, na sua 4a década de vida com diagnóstico de Hepatocarcinoma fibrolamelar com abordagem multimodal. A rara incidência desta neoplasia e a sua apresentação clínica incomum justificam a notificação deste caso e destacam a importância de equipas multidisciplinares no tratamento dos doentes oncológicos.

Keywords: Fibrolamellar carcinoma; Oncology; Rare tumors.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
MRI showing dimensional increase to more than the double (December 2016).
Fig. 2
Fig. 2
a Left lobectomy surgery with la­paroscopic hepatic and left gastric artery lymphadenectomy. b Histological finding compatible with pT1 N1 fibrolamellar hepatocellular carcinoma (3/5). HE. ×100.
Fig. 3
Fig. 3
MRI showing hilar adenopathy and small epiploon (September 2017).
Fig. 4
Fig. 4
PET-CT FDG with no evidence of distant disease (October 2017).
Fig. 5
Fig. 5
MRI confirming the presence of the single infracentimetric liver lesion in segment V. Status after locoregional treatment (September 2018).
Fig. 6
Fig. 6
MRI showing the appearance of two new segment VII lesions (February 2019).
Fig. 7
Fig. 7
CT scan where the ablation sites show no signs of viability, indicating complete response (June 2019).
See this image and copyright information in PMC

References

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