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Exophytic cystic liver lesion: an unusual presentation of a hepatocellular carcinoma in a young female
  1. Thomas Gardiner1,
  2. David Nasralla2,
  3. Eve Fryer3,
  4. Helen Bungay4,
  5. Michael Silva2
  1. 1 Medical Sciences Division, University of Oxford, Oxford, UK
  2. 2 Hepatobiliary Surgery, Churchill Hospital, Oxford, UK
  3. 3 Cellular Pathology, John Radcliffe Hospital, Oxford, UK
  4. 4 Department of Radiology, John Radcliffe Hospital, Oxford, UK
  1. Correspondence to Thomas Gardiner, thomas.gardiner{at}


Hepatocellular carcinoma (HCC) is one of the most common malignant primary liver tumours. However, primary hepatic carcinomas are rare in young adults, accounting for approximately 1% of tumours in people below the age of 20. Hepatitis B virus (HBV) and hepatitis C virus (HCV) infection are the two most important aetiological agents of HCC. The average age at onset of HBV-related HCC (~50 years old) is 10 years younger than that of HCV-related HCC (61–64 years). Evidence for an association between the oral contraceptive pill (OCP) and development of HCC remains inconclusive. Here, we describe a case of a 28-year-old woman with normal background liver, who presented with a large palpable abdominal mass due to a bilobar, exophytic, cystic lesion arising from the right lobe of the liver, later diagnosed as HCC on histological analysis. We highlight the need for considering HCC even in the unusual setting of a cystic, exophytic lesion.

  • hepatic cancer
  • surgical oncology
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  • Contributors TG and DN contributed equally to research and writing the paper. EF reviewed the manuscript and advised from histopathology view point. HB reviewed the manuscript and advised from radiology view point. MS did the overall supervision and reviewed the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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