Case Report
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World J Hepatol. Nov 27, 2012; 4(11): 322-326
Published online Nov 27, 2012. doi: 10.4254/wjh.v4.i11.322
Hepatocellular adenoma associated with familial adenomatous polyposis coli
Keisuke Inaba, Takanori Sakaguchi, Kiyotaka Kurachi, Hiroki Mori, Hong Tao, Toshio Nakamura, Yasuo Takehara, Satoshi Baba, Masato Maekawa, Haruhiko Sugimura, Hiroyuki Konno
Keisuke Inaba, Department of Surgery, Iwata City Hospital, Iwata 438-8500, Japan
Keisuke Inaba, Takanori Sakaguchi, Kiyotaka Kurachi, Toshio Nakamura, Hiroyuki Konno, Second Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan
Hiroki Mori, Hong Tao, Satoshi Baba, Haruhiko Sugimura, Department of Pathology, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan
Yasuo Takehara, Department of Radiology, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan
Masato Maekawa, Department of Laboratory Medicine, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan
Author contributions: Inaba K and Sakaguchi T treated the patient and wrote the manuscript; Kurachi K and Nakamura T treated the patient and helped to draft the report; Takehara Y reviewed the radiological features of the case; Tao H and Maekawa M examined the genetic alterations; Mori H, Baba S and Sugimura H contributed to the pathological examination and decided the final pathological diagnosis; Konno H was responsible for the patient management and supervised and approved the final manuscript.
Supported by The Japan Society for the Promotion of Science, No.17790258 and No.22591502
Correspondence to: Keisuke Inaba, MD, Department of Surgery, Iwata City Hospital, 512-3 Okubo, Iwata 438-8500, Japan. kinaba@hospital.iwata.shizuoka.jp
Telephone: +81-538-385000 Fax: +81-538-385050
Received: February 21, 2012
Revised: August 27, 2012
Accepted: October 22, 2012
Published online: November 27, 2012
Abstract

Hepatocellular adenoma (HCA) is a benign liver tumor that most frequently occurs in young women using oral contraceptives. We report a rare case of HCA in a 29 years old female with familial adenomatous polyposis (FAP). The first proband was her sister, who underwent a total colectomy and was genetically diagnosed as FAP. A tumor, 3.0 cm in diameter, was detected in the right lobe of the liver during a screening study for FAP. A colonoscopy and gastroendoscopy revealed numerous adenomatous polyps without carcinoma. The patient underwent a total colectomy and ileo-anal anastomosis and hepatic posterior sectoriectomy. The pathological findings of the liver tumor were compatible with HCA. The resected specimen of the colon revealed multiple colonic adenomatous polyps. Examination of genetic alteration revealed a germ-line mutation of the adenomatous polyposis coli (APC) gene. Inactivation of the second APC allele was not found. Other genetic alterations in the hepatocyte nuclear factor 1 alpha and β-catenin gene, which are reported to be associated with HCA, were not detected. Although FAP is reported to be complicated with various neoplasias in extracolic organs, only six cases of HCA associated with FAP, including the present case, have been reported. Additional reports will establish the precise mechanisms of HCA development in FAP patients.

Keywords: Hepatic adenoma; Familial adenomatous polyposis coli; Extrahepatic manifestation; Adenomatous polyposis coli gene; Hepatocyte nuclear factor 1 alpha