High Grade Dysplastic Nodule in a Non-Cirrhotic Liver in the Young

Abstract

Patients with high grade dysplastic nodule (HGDN) have an increased risk for development of hepatocellular carcinoma. Hepatocellular carcinoma (HCC) in a young patient with no cirrhosis or fibrosis is a relatively rare condition. HCC develops in patients in the setting of liver cirrhosis with established risk factors related to various etiologies including hepatitis virus infection, high alcohol intake or metabolic diseases. This was a case of a 29-year-old male with a 7-month history of intermittent right upper quadrant pain with CT scan findings of caudate lobe mass with malignant features. The patient underwent extended left hepatectomy with caudate lobectomy. Patient was discharged on fifth postoperative day, and was advised for follow-up surveillance on an outpatient basis. Liver cirrhosis is the main risk factor for developing HGDN, although rare cases of HGDN in a non-cirrhotic young patient should not be disregarded. Even though, it difficult to differentiate HGDN from early HCC based on radiologic imaging and histopathological criteria. Early diagnosis accompanied with proper surgical intervention such as anatomic resection and regular surveillance should be considered in the course and management of these patients, despite its rarity