Abstract
A 66-year-old white man had a hepatic resection for a 6-cm well-differentiated hepatocellular
carcinoma which had developed in a non-cirrhotic liver. The only risk factors found
were heavy drinking, smoking and heterozygosity for the C282Y mutation of the HFE
gene. The liver was mildly fibrotic and overloaded with iron. It also contained numerous
iron-free hepatocellular lesions from <1 to 10 mm, suggesting a premalignant change.
These lesions were of three types: (i) iron-free foci, (ii) hyperplastic nodules and
(iii) dysplastic nodules with severe dysplasia or even foci of well-differentiated
grade I hepatocellular carcinoma. This observation suggests the possibility of malignant
transformation of the liver in the newly-described syndrome of iron overload and normal
transferrin saturation. It also illustrates the multistep process of carcinogenesis
in the non-cirrhotic liver.
Keywords
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Article info
Publication history
Accepted:
August 6,
1998
Received in revised form:
July 14,
1998
Received:
May 13,
1998
Identification
Copyright
© 1999 Published by Elsevier Inc.
