Scirrhous hepatocellular carcinoma (S-HCC) represents an uncommon subtype of HCC. During radiological evaluation this unique subtype is frequently mistaken as cholangiocarcinoma, fibrolamellar HCC, or metastatic adenocarcinoma. Here, we present the case of a 50-year-old woman with a large hepatic mass. A triple-phase computed tomography of the liver revealed an arterial enhancing lesion without portovenous washout at hepatic segment 4a/8. The liver biopsy showed hepatocellular characteristics and was positive for Hep Par 1, CK7, CK19, Arginase 1 and CEA, indicating atypical S-HCC. This patient had achieved tumor control with combined treatment with atezolizumab plus bevacizumab and was then treated with lenvatinib after tumor progression. The patient died 15 months after the initial diagnosis.

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免疫治疗在罕见肝细胞癌亚型中的良好结果：病例报告和文献综述

硬质肝细胞癌 (S-HCC) 是 HCC 的一种罕见亚型。在放射学评估过程中，这种独特的亚型经常被误认为是胆管癌、纤维板层肝癌或转移性腺癌。在这里，我们介绍一位 50 岁女性的病例，她患有巨大的肝脏肿块。肝脏三相计算机断层扫描显示肝段 4a/8 处有动脉增强病变，无门静脉冲洗。肝活检显示肝细胞特征，Hep Par 1、CK7、CK19、精氨酸酶 1 和 CEA 呈阳性，表明非典型 S-HCC。该患者通过阿特朱单抗加贝伐单抗联合治疗实现了肿瘤控制，并在肿瘤进展后接受乐伐替尼治疗。患者在初次诊断后 15 个月死亡。