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Korean J Gastroenterol  <  Volume 73(5); 2019 <  Articles

Korean J Gastroenterol 2019; 73(5): 303-307  https://doi.org/10.4166/kjg.2019.73.5.303
Cystic Degeneration of Hepatocellular Carcinoma Mimicking Mucinous Cystic Neoplasm
Jangwon Lee1, Namhee Lee1, Hye Kyoung Yoon2, Yeon Jae Lee1 and Sung Jae Park1,3
Departments of Gastroenterology and Hepatology1 and Pathology2, Inje University Busan Paik Hospital, Inje University College of Medicine, Paik Institute for Clinical Research3, Busan, Korea
Correspondence to: Sung Jae Park, Department of Gastroenterology and Hepatology, Inje University Busan Paik Hospital, Inje University College of Medicine, 75 Bokji-ro, Busanjin-gu, Busan 47392, Korea. Tel: +82-51-890-6114, Fax: +82-51-891-1906, E-mail: yaheaven@hanmail.net, ORCID: https://orcid.org/0000-0002-1512-5047
Received: November 19, 2018; Revised: January 15, 2019; Accepted: January 18, 2019; Published online: May 25, 2019.
© The Korean Journal of Gastroenterology. All rights reserved.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Spontaneous regression of tumors is an extremely rare event in hepatocellular carcinoma (HCC) with only a few reports available. With the accumulation of clinical information and tumor immunogenetics, several mechanisms for the cystic changes of HCC have been suggested, including arterial thrombosis, inflammation, and rapid tumor growth. This paper reports an uncommon case of the partial regression of HCC, which was initially misdiagnosed as a mucinous cystic neoplasm of the liver due to the unusual radiologic findings. A 78-year-old female with the hepatitis B virus and liver cirrhosis presented with an approximately 5 cm-sized cystic mass of the liver. From the radiologic evidence of a papillary-like projection from the cyst wall toward the inner side, the initial impression was a mucinous cystic neoplasm of the liver. The patient underwent a surgical resection and finally, cystic degeneration of HCC, in which approximately 80% necrosis was noted. This case suggests that if a cystic neoplasm of liver appears in a patient with a high risk of HCC on a hepatobiliary imaging study, it is prudent to consider the cystic degeneration of HCC in a differential diagnosis.
Keywords: Liver neoplasms; Magnetic resonance imaging; Diagnostic errors


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