Giant Hepatocarcinoma i n Healthy Liver: Case Report

Introduction: Hepatocarcinoma corresponds to the 5th most common cancer worldwide. Multifactorial etiology:infection by HBV or HCV and alcoholic cirrhosis, among the most frequent. Rare in healthy liver. Alpha-1-antitrypsin deficiency within the main causes. Clinical Case:Male, 65 years old, with no morbid history or alcohol consumption. Consultation for abdominal volume increase. Abdominal MRI confirms giant right hepatic tumor of 17 cm. Serology for HBV and negative HCV, normal alpha-fetoprotein and normal Ca19-9. Extended right hepatectomy is performed. Definitive biopsy confirms well differentiated hepatocellular carcinoma. Immuno histochemistry identifies intracyt oplasmic antitrypsin granules confirming the diagnosis of alpha-1 antitrypsin deficiency. Discussion: The real incidence of HCC in non-cirrhotic liver is uncertain, ranging between 10 and 50% of the resected HCC. The deficiency of alpha-1-anti trypsin generates liver disease characterized by the accumulation of the protein in the endoplasmic reticulum of the hepatocyte, which eventually leads to cell damage. This cell damage manifests itself as fibrosis and subsequent cirrhosis, or as a hepatocarcinoma. Conclusion: Hepatocarcinoma is malignant tumor with known risk factors. It is necessary to consider the deficit of AAT in context of healthy liver.