TANIAI Makiko    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Associate Professor
Article types	Case report
Language	English
Peer review	Non peer reviewed
Title	Hepatocellular carcinoma in young morbid obese patients with non-alcoholic fatty liver disease.
Journal	Formal name：Clinical journal of gastroenterology Abbreviation：Clin J Gastroenterol ISSN code：18657265/18657265
Domestic / Foregin	Domestic
Volume, Issue, Page	13(6),pp.1289-1296
Author and coauthor	TOBARI Maki, HASHIMOTO Etsuko, TANIAI Makiko, NISHINO Takayoshi, TOKUSHIGE Katsutoshi, Nishino Takayoshi
Publication date	2020/12
Summary	We report the two youngest cases of hepatocellular carcinoma (HCC) in non-alcoholic fatty liver disease (NAFLD) among our 119 NAFLD-HCC patients. A 36-year-old man was referred to our hospital due to a 5 cm in diameter liver tumor with elevation of α-fetoprotein and des-γ-carboxy prothrombin found at his annual health check. He had no symptoms other than 20 kg weight loss. He has been morbidly obese since he was a child. At the time of the diagnosis of NAFLD-HCC, blood chemistry showed FIB4-index 0.52, α-fetoprotein 11.1 ng/mL and des-γ-carboxy prothrombin 361 mAU/mL. He underwent curative operation. The non-cancerous lesion showed steatohepatitis with mild fibrosis. A 41-year-old man was diagnosed as having a huge liver tumor (15 cm in diameter) during medical examination for 10 kg weight loss. He had no clinical symptoms except weight loss. He has been morbidly obese since childhood. NAFLD was diagnosed at age 20. At the time of the HCC diagnosis, blood chemistry showed FIB4-index 1.42, α-fetoprotein 1974 ng/mL, and des-γ-carboxy prothrombin 82,602 mAU/mL. He underwent curative operation. We have to be aware that HCC can develop in young NAFLD patients without advanced fibrosis. Concerning tumor markers, elevation of des-γ-carboxy prothrombin was more sensitive than α-fetoprotein.
DOI	10.1007/s12328-020-01215-3
PMID	32880022