A case of sclerosing hepatocellular carcinoma diagnosed by needle biopsy under laparoscopy

A 53-year-old male patient with sclerosing hepatocellular carcinoma is reported. We encountered a case of multiple liver tumors. Computed tomography (CT) revealed multiple low density areas in the liver. Peripheral portion of these areas showed definite contrast-enhancement on CT. Under laparoscopy, the tumor was revealed to be white and have irregular surface with umbilication, and peritoneal dissemination of the tumor was found. Although these findings suggest the diagnosis of metastatic liver tumors, the needle biopsy from one of the tumors showed the presence of hepatocellular carcinoma. Dense fibrosis was arranged around the rather eosinophilic polygonal neoplastic hepatocytes. This distinct morphologic appearance is identical to that of sclerosing hepatocellular carcinoma which was previously defined by Peters. The hepatic tumor invaded the duodenum, and he died of respiratory failure due to pleural metastasis.