A 37-year-old woman presented with a mass in the right hypochondrium for one month and without other symptoms.
She had been taking contraceptives for 12 years and had not had previous transfusions.
She was diagnosed seven years ago with B virus infection due to pregnancy.
His family history included a mother diagnosed with liver cirrhosis.
The physical examination showed hepatomegaly 5 cm below the costal margin, without stenosis or ascites.
Blood count and liver function tests were normal.
Alpha-fetoprotein (AFP): 1,556.30 IU/ml (normal values: 0-10 IU/ml).
Serology hepatitis B: HBsAg positive; anti-HBs negative; HBeAg negative; anti-HBe positive; anti-HBc positive.
Ultrasound and abdominal computerized axial tomography (CAT) revealed a well-defined heterogeneous mass of 12 cm in diameter, occupying hepatic segments 5 and 6, with no signs of vascular invasion and displacing the right portal vein.
Segments 5 and 6 were resected with 10-minute liver preconditioning and ultrasound control, without complications.
The patient died at 10 months due to tumor progression.
Macroscopic report: a well-defined 11 cm polypoid mass displacing the normal hepatic parenchyma.
It is a solid tumor with a "gray" appearance, limited by thin fibrous septa.
Microscopically, neoformation consists of epithelial cells that are separated fibrous capsule and tubular structures, as well as cords by vascularized fibrous tissue separated from the normal hepatic parenchyma vascularized by one.
The cells are of normal size, with a basophilic cytoplasm and nuclei of fetal and embryonic appearance, or oval-shaped.
There are frequent images of mitosis without vascular or capsule invasion.
Tumor cells showed intense immunoreactivity against hepatocyte cytokeratin CAM5.2 and focally against cytokeratin AE3/AE1.
The remaining markers for chromogranin, synaptophysin and desmosin were negative.
