Fibrolamellar carcinoma presenting as a pancreatic mass: case report and review of the literature

Fibrolamellar carcinoma is a subtype of hepatocellular carcinoma with distinct clinicopathologic features including presentation at a younger age. Although early studies suggested that fibrolamellar carcinoma had a better prognosis than conventional hepatocellular carcinoma, most later studies have found no difference. Patients often have lymph node metastases at presentation in addition to the hepatic primary. We describe an unusual case in a Thai boy who presented with a pancreatic mass that was clinically suspected to be a primary pancreatic tumor, but on biopsy was found to be metastatic fibrolamellar carcinoma. To our knowledge, this manner of presentation has not been previously reported for fibrolamellar carcinoma, nor has metastatic spread to the pancreas.