Fibrolamellar Carcinoma of the Liver in a Middle-aged Korean Man

A 42-year-old Korean man with a fibrolamellar carcinoma of the liver is described. His initial symptom was an epigastric mass without pain, which resulted in a left lobectomy of the liver. A whitish and hard tumor, 10 cm in maximum diameter, without any cirrhotic features was noted in the resected liver. Histologically, the tumor was composed of lamellarly distributed fibrous stroma and polyhedral large cancer cells, which showed eosinophilic granular cytoplasm and rounded nuclei. Prominent nucleoli, scattered pale bodies and numerous copper-binding protein deposits were seen in the cancer cells. Orcein-stain failed to show HBsAg-laden cells in both the cancerous and non-cancerous tissues, and alpha-fetoprotein was not seen in the cancer cells by an immuno-peroxidase staining. Fibrolamellar carcinoma has been found almost exclusively in Caucasians and is very rare in Orientals. We describe this rare case with a review of the literature.