부산대학교 도서관

A case of extrahepatic pedunculated anaplastic hepatoma occuring in a 52-year-old male was reported. The patient was admitted to the hospital with the chief complaint of a gradually increasing epigastric mass. The preoperative physical examination and imaging procedure failed to show the accurate nature of the tumor. An ultrasonically guided aspiration cytology performed prior to the operation was diagnosed as leiomyosarcoma based on the findings of a remarkable variation, both in size and shape, of the tumor cells with occasional intracytoplasmic thin filaments. Many tumor cells had multiple or bizarre nuclei. Mitotic figures were frequently seen.Surgery revealed a pedunculated tumor, 23×15×10 cm in size and 1, 800g in weight, underneath the right lobe of the liver connected with cord-like fibrous tissue. The liver showed cirrhotic change, however, no tumorous nodules were observed.Histology of the resected tumor showed sarcoma-like appearance in a large portion of the tumor. However, the silver impregnation method used for the tumor preserved the architecture of an alveolar pattern. In a small portion of the tumor adjacent to the peduncle there appeared hepatocellular carcinoma with trabecular pattern. Electron microscopic findings also suggested hepatocellular carcinoma because of the findings of numerous microvilli on the surfaces of the tumor cells with the formation, though incomplete, of bile canaliculus-like spaces. The patient has been in good health for the past 3 years since the surgery.