Hepatocellular carcinoma (HCC) is one of the most important causes of cancer death in South Korea. Approximately two
thirds of the patients are diagnosed in the advanced stage with multiple metastasis and underlying liver dysfunction, so they are
not suitable to undergo curative resection. Small HCC has no consensus about diagnostic criteria but became known early stage
HCC that means good prognosis. Cases of small HCC have been increasing with the progress of diagnostic methods. We
experienced a case of incidentally found small HCC less than 1 cm from liver cirrhosis by liver dynamic imaging, so reported it.
Dysplastic nodule (DN) is considered as precancerous lesion of hepatocellular carcinoma (HCC). There are several evidences to support the theory about multistep progression of hepatocarcinogenesis. Recently we experienced a patient with HCC of the
odule-in-nodule pattern, namely small HCC within DN, which supported the multistep theory of hepatocarcinogenesis. The tumor was seen as a 3 cm, arterial enhancing mass with delayed wash-out patterns in the segment Ⅶ at helical CT. The patient was treated by surgical resection. A 3.0×2.5 cm mass was seen in the resected specimen. A 2.2×1.5 cm, smaller nodule was observed within this mass, i.e. the
odule-in-nodule pattern. Microscopically, various grades of HCC foci were seen within high grade DN. Because DN does not always progress to HCC, further studies are needed to evaluate what kind of DN has the high possibility of progressing of HCC at last.