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Diagnostic Dilemma of Hepatocellular Carcinoma Presenting as Hepatic Angiomyolipoma

Case in Point
Federal Practitioner. 2011 April;28(4):28
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Although this patient’s initial imaging and laboratory test results suggested hepatic angiomyolipoma, repeat pathologic analysis finally confirmed
a diagnosis of hepatocellular carcinoma.

Hepatocellular carcinoma (HCC) usually develops in patients who have a history of chronic liver disease. In fact, 77% of HCC cases are associated with chronic viral hepatitis, and 62% are associated with liver cirrhosis; only 7% of liver cancers are found to emanate from a normal liver bed.1 Clear-cell HCC is a rare type of liver cancer, accounting for 7% to 12% of all liver cancer cases.2 Although clear or fatty cellular changes may be seen frequently in early HCCs, they are relatively uncommon in larger cancers.3