Interesting Case of the Month - (IGHP, ICOM) - August
august 2025
Clinical History-
67-year-old malewithabdominal pain and features of acute enteritis. AFP- normal, Serology- for viral markers negative.
From the images below identify the likely disease?
Radiology-
USG-
Liver showed a solitary mass measuring 3.0 x 2.8 cm. Adjacent liver tissue showed heterogenous liver parenchyma.
Microscopic Images-
Microscopic examination showed a population of atypical cells with clear cytoplasm.
Immunohistochemistry-
Immunohistochemistry performed showed the clear cells are diffusely positive for Arginase and Glypican 3
Diagnosis-
Steatohepatitic Hepatocellular Carcinoma
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Adrenal Cell Carcinoma
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Cholangiocarcinoma
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Clear Cell Hepatocellular Carcinoma
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Clear cell hepatocellular carcinoma is a rare variant of HCC. Majority of these tumours have serum alpha-fetoprotein (AFP) levels of ≤ 20 ng/ml. Radiologically most cases present as solitary intra-parenchymal mass lesions which have well-defined boarders. On pre-contrast CT scans, they mostly show hypo-attenuation and occasionally as isointense to the adjacent liver parenchyma. CCHCC are classified as neoplasm with greater than 50% clear cells.