SCLEROSING HEPATOCELLULAR-CARCINOMA WITHO UT HYPERCALCEMIA

The sclerosing hepatocellular carcinoma is an unusual subtype of hepat ocellular carcinoma characterized by an intense fibrous stroma in whic h the tubular structures are embedded. Histological diagnosis is diffi cult, and misinterpretation as cholangiocarcinoma or metastatic adenoc arcinomas may occur. It usually presents on non-cirrhotic livers. Meta stases located outside of the liver are frequent as well as hypercalce mia and low levels of serum phosphate. We report a case of this rare h istopathologic subtype of hepatocellular carcinoma in a 35-year-old wo man, asymptomatic and with no previous history of of chronic liver dis ease. It was detected by a routine gynaecological ultrasonography. An important increase of serum alpha-fetoprotein was noted. Extension stu dies showed bilateral lung metastases. Several palliative teraphies we re tried out, including epirrubicin, with partial response. Twenty mon ths after the diagnosis the patient' situation is nearly terminal.