A Case-Based Review of Advanced Surgical Techniques in the Treatment of Incidentally Diagnosed Fibrolamellar Hepatocellular Carcinoma

TL;DR

This paper presents a case of a rare liver tumor found incidentally in a healthy young man and successfully treated with advanced surgical techniques.

Contribution

The paper highlights the use of advanced surgical techniques for managing large FL-HCC tumors.

Findings

FL-HCC was incidentally diagnosed in a healthy 25-year-old male during evaluation for flank pain.

A right hepatectomy using advanced techniques led to an uneventful recovery.

Incidental findings should be thoroughly evaluated, even in asymptomatic individuals.

Abstract

Fibrolamellar hepatocellular carcinoma (FL-HCC) is a rare liver tumor that typically affects young adults without underlying liver disease. This case describes an incidental diagnosis of FL-HCC in a healthy 25-year-old male who presented to the Emergency Department with left flank pain. Imaging revealed a ureteropelvic junction stone with moderate hydronephrosis, as well as an unexpectedly large right hepatic mass. Further evaluation confirmed the diagnosis of FL-HCC. The patient underwent a successful right hepatectomy utilizing the anterior approach with hanging maneuver and extra-Glissonian right pedicle control. Postoperatively, the patient experienced an uneventful recovery.

This case highlights the importance of thorough evaluation of incidental findings, even in asymptomatic and healthy individuals, and demonstrates the advantages of advanced surgical techniques in managing large liver tumors.

Figures