PET-CT scan is a valuable modality in the diagnosis of fibrolamellar hepatocellular carcinoma: a case report and a summary of recent literature.

We report a case of liver cancer with features consistent with fibrolamellar hepatocellular carcinoma (FLHCC) detected by PET-CT scan. A 20-year-old female with a large liver tumor was diagnosed with 'malignant hepatic tumor' 2 years earlier and received five courses of transhepatic arterial chemoembolization (TACE) before she presented to our hospital with abdominal distension and mild pain at the right upper quadrant. Ultrasound and CT scan showed a large tumor in the right lobe of the liver. Contrast CT scan and (18)F-FDG PET-CT showed metastatic lesions in multiple organs. The imaging diagnosis was confirmed by an ultrasound-guided fine needle biopsy of the hepatic lesion which showed features of FLHCC. Immunohistochemical staining showed a marked increase in the expressions of Hepar, CD99, MIB1, proliferating cell nuclear antigen (PCNA), Fibronectin, E-cadherin and CK7. The recent knowledge on the FLHCC and the possible applications of PET-CT were discussed.