case_images: PMC9539137_01
case_images: Ct image with irregular and slightly low-density shadows indicating a hepatocellular carcinoma lesion in the right lobe of the liver, near the top of the diaphragm (arrow).
case_images: fsurg-09-963182-g001.jpg
case_images: PMC9539137_01_fsurg-09-963182-g001.jpg
case_images: F1
case_images: On computed tomography examination, irregular and slightly low-density (~26 HU) shadows were observed in the right lobe of the liver, near the top of the diaphragm, representing a tumor measuring 29 x 23 mm with clear boundaries (Figure 1).
case_images: (A) The hepatocellular carcinoma had a trabecular structure, with some translucent cells. H/E staining, magnification 100x. (B) Multiple satellite nodules were present around the main tumor nodule (red arrow). Liver tissue 0.5 cm from the main tumor had a benign-appearing follicular thyroid structure (black arrow). H/E staining, magnification 20x. (C) The follicular epithelial cells showed no atypia. H/E staining, magnification 100x. (D) Immunohistochemical staining of the hepatocellular carcinoma was negative for CK-19 (D) and positive for GPC-3 (E). Magnification 100x. Immunohistochemical staining of the ectopic thyroid epithelial cells was positive for TG (F), PAX-8 (G), and TTF-1 (H). Magnification 100x.
case_images: fsurg-09-963182-g002.jpg
case_images: PMC9539137_01_fsurg-09-963182-g002.jpg
case_images: F2
case_images: Some tumor cells were translucent, and multiple satellite nodules were found around the main tumor nodule (Figures 2A,B). An area of liver tissue (~0.3 cm) located 0.5 cm from the main tumor had a benign-appearing follicular thyroid structure (Figures 2B,C). Immunohistochemical (IHC) analysis of the hepatocellular carcinoma revealed hepatocyte antigen positivity, cytokeratin-19 negativity (Figure 2D), and glypican-3 (GPC-3) positivity (Figure 2E). Epithelial cells in the area with a follicular thyroid structure showed no atypia; they were negative for hepatocyte paraffin 1 (Hep Par-1) and positive for thyroglobulin (TG) (Figure 2F), PAX8 (Figure 2G), and thyroid transcription factor-1 (TTF-1; Figure 2H).