Fibrolamellar Hepatocellular Carcinoma in a Thai Man
Who Presented with Hypoglycemia : Case Report and
Review of Literature
PIS IT TANGKUV ANICH, M.D.*,
PINIT KULLA V ANUA Y A, M.B.Ch.B., F.R.C.P. **,
DUANGPORN THONG-NGAM, M.D.**,
PONGSEPEERA SUW ANGOOL M.D.***
Affiliation : * Department of Biochemistry,
** Gastroenterology Unit, Department of Medicine,
*** Department of Pathology, Faculty of Medicine, Chulalongkom University Hospital, Bangkok 10330, Thailand.
AbstractWe present a case of fibrolamellar hepatocellular carcinoma (FLHCC) in a 22 year old
Thai man whose presenting symptom was hypoglycemic coma with right hemiparesis. The serum
marker for hepatitis B virus (HBsAg) was positive and serum AFP was very high (over I 00,000
IU/ml). The abdominal ultrasonography revealed a solitary heterogenic mass, size 5.5x6.5 em in
the right lobe. Chest X-ray showed multiple lung metastases. Ultrasound-guided needle liver
biopsy was performed and typical histologic features of FLHCC in non-cirrhotic liver were
diagnosed. The patient's comatose state and neurological deficits recovered rapidly after glucose
administration. Unfortunately, the tumor mass could not be resected on account of far-advanced
stage v.'ith metastases. Here, we also review of the literature concerning FLHCC in many
aspects.
Keywords : Fibrolamellar Hepatocellular Carcinoma, Hypoglycemia
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