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Fibrolamellar Carcinoma
Atif Zaheer, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Fibrolamellar carcinoma (FLC) of liver
            • Synonyms

              • Fibrolamellar hepatocellular carcinoma (HCC)
            • Definitions

              • Uncommon, malignant hepatocellular tumor
                • Distinct clinical, histopathologic, and imaging features differentiate it from conventional HCC

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Angiographic Findings

                      • Nuclear Medicine Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Gigante E et al: New insights into the pathophysiology and clinical care of rare primary liver cancers. JHEP Rep. 3(1):100174, 2021
                                                2. Ramai D et al: Fibrolamellar hepatocellular carcinoma: a population-based observational study. Dig Dis Sci. 66(1):308-14, 2021
                                                3. Dong Y et al: Imaging features of fibrolamellar hepatocellular carcinoma with contrast-enhanced ultrasound. Ultraschall Med. ePub, 2020
                                                4. Graham RP: Fibrolamellar carcinoma: what is new and why it matters. Surg Pathol Clin. 11(2):377-87, 2018
                                                5. Palm V et al: Imaging features of fibrolamellar hepatocellular carcinoma in gadoxetic acid-enhanced MRI. Cancer Imaging. 18(1):9, 2018
                                                6. Lafaro KJ et al: Fibrolamellar hepatocellular carcinoma: current clinical perspectives. J Hepatocell Carcinoma. 2:151-7, 2015
                                                7. Ganeshan D et al: Imaging features of fibrolamellar hepatocellular carcinoma. AJR Am J Roentgenol. 202(3):544-52, 2014
                                                8. Roth CG et al: Hepatocellular carcinoma and other hepatic malignancies: MR imaging. Radiol Clin North Am. 52(4):683-707, 2014
                                                9. Mayo SC et al: Treatment and prognosis of patients with fibrolamellar hepatocellular carcinoma: a national perspective. J Am Coll Surg. 218(2):196-205, 2014
                                                10. Taylor SL et al: Hepatobiliary pathology. Curr Opin Gastroenterol. 27(3):248-55, 2011
                                                11. Ward SC et al: Fibrolamellar carcinoma: a review with focus on genetics and comparison to other malignant primary liver tumors. Semin Liver Dis. 31(1):61-70, 2011
                                                12. Fouzas I et al: "Preemptive" live donor liver transplantation for fibrolamellar hepatocellular carcinoma: a case report. Transplant Proc. 40(10):3806-7, 2008
                                                13. Smith MT et al: Best cases from the AFIP: fibrolamellar hepatocellular carcinoma. Radiographics. 28(2):609-13, 2008
                                                14. Ichikawa T et al: Fibrolamellar hepatocellular carcinoma: pre- and posttherapy evaluation with CT and MR imaging. Radiology. 217(1):145-51, 2000
                                                15. Ichikawa T et al: Fibrolamellar hepatocellular carcinoma: imaging and pathologic findings in 31 recent cases. Radiology. 213(2):352-61, 1999
                                                16. McLarney JK et al: Fibrolamellar carcinoma of the liver: radiologic-pathologic correlation. Radiographics. 19(2):453-71, 1999
                                                17. Schlitt HJ et al: Recurrence patterns of hepatocellular and fibrolamellar carcinoma after liver transplantation. J Clin Oncol. 17(1):324-31, 1999
                                                18. Stevens WR et al: Fibrolamellar hepatocellular carcinoma: stage at presentation and results of aggressive surgical management. AJR Am J Roentgenol. 164(5):1153-8, 1995
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Abbreviations

                                                            • Fibrolamellar carcinoma (FLC) of liver
                                                          • Synonyms

                                                            • Fibrolamellar hepatocellular carcinoma (HCC)
                                                          • Definitions

                                                            • Uncommon, malignant hepatocellular tumor
                                                              • Distinct clinical, histopathologic, and imaging features differentiate it from conventional HCC

                                                          IMAGING

                                                          • General Features

                                                            • CT Findings

                                                              • MR Findings

                                                                • Ultrasonographic Findings

                                                                  • Angiographic Findings

                                                                    • Nuclear Medicine Findings

                                                                      • Imaging Recommendations

                                                                        DIFFERENTIAL DIAGNOSIS

                                                                          PATHOLOGY

                                                                          • General Features

                                                                            • Staging, Grading, & Classification

                                                                              • Gross Pathologic & Surgical Features

                                                                                • Microscopic Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Gigante E et al: New insights into the pathophysiology and clinical care of rare primary liver cancers. JHEP Rep. 3(1):100174, 2021
                                                                                              2. Ramai D et al: Fibrolamellar hepatocellular carcinoma: a population-based observational study. Dig Dis Sci. 66(1):308-14, 2021
                                                                                              3. Dong Y et al: Imaging features of fibrolamellar hepatocellular carcinoma with contrast-enhanced ultrasound. Ultraschall Med. ePub, 2020
                                                                                              4. Graham RP: Fibrolamellar carcinoma: what is new and why it matters. Surg Pathol Clin. 11(2):377-87, 2018
                                                                                              5. Palm V et al: Imaging features of fibrolamellar hepatocellular carcinoma in gadoxetic acid-enhanced MRI. Cancer Imaging. 18(1):9, 2018
                                                                                              6. Lafaro KJ et al: Fibrolamellar hepatocellular carcinoma: current clinical perspectives. J Hepatocell Carcinoma. 2:151-7, 2015
                                                                                              7. Ganeshan D et al: Imaging features of fibrolamellar hepatocellular carcinoma. AJR Am J Roentgenol. 202(3):544-52, 2014
                                                                                              8. Roth CG et al: Hepatocellular carcinoma and other hepatic malignancies: MR imaging. Radiol Clin North Am. 52(4):683-707, 2014
                                                                                              9. Mayo SC et al: Treatment and prognosis of patients with fibrolamellar hepatocellular carcinoma: a national perspective. J Am Coll Surg. 218(2):196-205, 2014
                                                                                              10. Taylor SL et al: Hepatobiliary pathology. Curr Opin Gastroenterol. 27(3):248-55, 2011
                                                                                              11. Ward SC et al: Fibrolamellar carcinoma: a review with focus on genetics and comparison to other malignant primary liver tumors. Semin Liver Dis. 31(1):61-70, 2011
                                                                                              12. Fouzas I et al: "Preemptive" live donor liver transplantation for fibrolamellar hepatocellular carcinoma: a case report. Transplant Proc. 40(10):3806-7, 2008
                                                                                              13. Smith MT et al: Best cases from the AFIP: fibrolamellar hepatocellular carcinoma. Radiographics. 28(2):609-13, 2008
                                                                                              14. Ichikawa T et al: Fibrolamellar hepatocellular carcinoma: pre- and posttherapy evaluation with CT and MR imaging. Radiology. 217(1):145-51, 2000
                                                                                              15. Ichikawa T et al: Fibrolamellar hepatocellular carcinoma: imaging and pathologic findings in 31 recent cases. Radiology. 213(2):352-61, 1999
                                                                                              16. McLarney JK et al: Fibrolamellar carcinoma of the liver: radiologic-pathologic correlation. Radiographics. 19(2):453-71, 1999
                                                                                              17. Schlitt HJ et al: Recurrence patterns of hepatocellular and fibrolamellar carcinoma after liver transplantation. J Clin Oncol. 17(1):324-31, 1999
                                                                                              18. Stevens WR et al: Fibrolamellar hepatocellular carcinoma: stage at presentation and results of aggressive surgical management. AJR Am J Roentgenol. 164(5):1153-8, 1995