[A case of glycogen storage disease type I with hepatocellular carcinoma].

The patient was a 55-year-old female. In 1997, she was diagnosed as type-I glycogen storage disease (von Gierke disease). In March 2002, abdominal ultrasound tomography revealed an early enhanced lesion at liver S2, which suspected to a well differentiated hepatocellular carcinoma (HCC) with super-paramagnetic iron oxide (SPIO) enhanced magnetic resonance imaging (MRI). From 2002 to 2006, she received three times trans-arterial chemo-embolization (TACE) at enhanced lesions. But abdominal computer tomography (CT) revealed a 3.6 cm-in diameter early enhanced lesion near this tumor at S2, which was suspected to a diagnosis of recurrent HCC in December 2008. Therefore, she received a partial hepatectomy at S2. This resected specimen was diagnosed as poorly differentiated HCC. This patient is still alive with no recurrence after 6 months from operation. In conclusion, it might be effective for an early detection of recurrent HCC to see the doctor for a long regular checkup, because the growth of HCC with glycogen storage disease would be very slow.

[A case of hepatocellular carcinoma which could be diagnosed with Gd-EOB-DTPA enhanced MRI].

The patient was a 75-year-old female. In 2005, abdominal computer tomography (CT) revealed a 18 mm-in-diameter early enhanced lesion (tumor A) in S8, which was diagnosed as hemangioma of liver with abdominal simple MRI examination. However, abdominal computer tomography (CT) revealed a 16 mm-in-diameter early enhanced lesion (tumor B) near the tumor A to at S8 in April 2008. Both tumor A and tumor B led to a diagnosis of hepatocellular carcinoma (HCC) with Gd-EOB-DTPA enhanced magnetic resonance imaging (MRI) (tumor A was suspected to HCC with adipose components, and tumor B was suspected to HCC with bile excretion disorder). In July 2008, he received S8 partial hepatectomy at these hepatic tumors. In this resected specimen, a new lesion was detected as a 7 mm-in-diameter HCC, sandwiched in previous two tumors. Previous two tumors were diagnosed as well differentiated HCCs and a new lesion was diagnosed as moderately differentiated HCC. This patient is still alive with no recurrence after 14 months from hepatectomy. In conclusion, Gd-EOB-DTPA enhanced MRI might be useful in diagnosis of hepatic tumor characteristics.