FIBROLAMELLAR HEPATIC CARCINOMA IN AN AREA WITH A LOW INCIDENCE OF PRIMARY LIVER-CANCER - A RETROSPECTIVE STUDY

Objective: To assess the incidence and prognosis of fibrolamellar hepa tic carcinoma in a defined population. Design: Retrospective study of histological slides. Setting: University hospital, Sweden. Subjects: T he 532 patients (out of a total of 711 who were treated at the univers ity hospital during a 22 year period 1 January 1958-31 December 1979) whose primary hepatocellular carcinoma was confirmed on review of the histological slides. Main outcome measures: Incidence and prognosis of fibrolamellar hepatic carcinoma. Results: Two patients (women aged 22 and 46) were found to have fibrolamellar tumours and in both they wer e advanced and the patients died 2 weeks and 9 months, respectively, a fter exploratory laparotomy. If these are taken as a proportion of the 18 patients who were under the age of 50 at the time of diagnosis the n the incidence of the fibrolamellar type of hepatocellular carcinoma is 11%. Since then (in 1993) we have come across one further case, a w oman of 39 who was well 22 months after operation though she had metas tatic disease. Conclusions: The fibrolamellar type of hepatocellular c arcinoma is rare, and all three of our cases were young women (under t he age of 50). It seems to have a slightly better prognosis than other types of primary hepatic tumours.