Abstract

Spontaneous total necrosis of hepatocellular carcinoma is extremely rare, with only 16 cases reported in the English literature. In this report, we describe a case of spontaneous totally necrotic hepatocellular carcinoma in a 53-year-old man who was previously healthy. The hepatic mass was incidentally found. The viral markers for hepatitis B and C were negative and alpha-fetoprotein was normal. Ultrasonography revealed hypoechoic mass with peripheral high echoic rim. On CT, the mass was hypodense in both hepatic arterial phase and portal venous phase. Subtle capsular enhancement was noted in portal venous phase CT. The patient underwent hepatic segmentectomy. The resected hepatic segment revealed 4.5 cm sized, well encapsulated, and nearly totally necrotic mass. On microscopic examination, the ghost cells of hepatocellular carcinoma were found in totally necrotic tissue, supporting diagnosis of hepatocellular carcinoma.

• Keywords: Liver;Hepatocellular carcinoma;Necrosis