Pediatr Gastroenterol Hepatol Nutr.  2015 Jun;18(2):144-148. 10.5223/pghn.2015.18.2.144.

Atypical beta-Catenin Activated Child Hepatocellular Tumor

• Turan A
• Unlu HA
• Karakus E
• Yazal Erdem A
• Yakut ZI

• KMID: 2315563
• DOI: http://doi.org/10.5223/pghn.2015.18.2.144

Abstract

Hepatocellular adenomas are a benign, focal, hepatic neoplasm that have been divided into four subtypes according to the genetic and pathological features. The beta-catenin activated subtype accounts for 10-15% of all hepatocellular adenomas and specific magnetic resonance imaging features have been defined for different hepatocellular adenomas subtypes. The current study aimed to report the magnetic resonance imaging features of a well differentiated hepatocellular carcinoma that developed on the basis of beta-catenin activated hepatocellular adenomas in a child. In this case, atypical diffuse steatosis was determined in the lesion. In the literature, diffuse steatosis, which is defined as a feature of the hepatocyte nuclear factor-1alpha-inactivated hepatocellular adenomas subtype, has not been previously reported in any beta-catenin activated hepatocellular adenomas case. Interlacing magnetic resonance imaging findings between subtypes show that there are still many mysteries about this topic and larger studies are warranted.

Keyword

Adenoma; Liver; Hepatocellular carcinoma; Magnetic resonance imaging; Beta-catenin

MeSH Terms

Adenoma
Adenoma, Liver Cell
beta Catenin*
Carcinoma, Hepatocellular
Child*
Hepatocytes
Humans
Liver
Liver Neoplasms
Magnetic Resonance Imaging
beta Catenin

Figure

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  Fig. 1 A large fatty mass (arrow) was observed in right liver lobe in contrasted axial computed tomography. The hounsfield unit of the central point circle was -37.

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  Fig. 2 (A) A hypo-intense central scar (arrow) was observed in a heterogeneous, mild hyperintense lesion in the T1 axial plan of abdominal magnetic resonance imaging and (B) there was an abundant depression of the lesion in out of phase images (arrow).

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  Fig. 3 In the T2-weighted (A) coronal and (B) axial images, a central scar (arrow) present in the lesion.

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  Fig. 4 (A) In the dynamic evaluation, a slightly heterogeneous contrasting lesion was present in the arterial phase prominent in septates (arrow), (B) in portal venous phase enhancement in the septates became more evident (arrow), and (C) a central scar was considerably contrasted in the late phase taken at the first hour (arrow).

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  Fig. 5 (A) Macroscopically, a tumoral lesion showing a nodular growth pattern with large and small many nodulations in the cut surface. (B) Microscopically, the tumor cells were pleomorphic with large, transparent cytoplasm and hyperchromatic nuclei showing prominent nucleoli (H&E, ×100).

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