An Unexpected Hepatocellular Carcinoma arising From an Unknown Nonalcoholic Fatty liver

Development of Hepatocellular Carcinoma in the context of Non-Alcoholic Fatty Liver Disease is an issue of serious concern in a landscape where NAFLD has rapidly become a major condition of liver illness. NAFLD is often misdiagnosed, as these patients are asymptomatic and their laboratory tests are within normal range. We hereby present the case of a 34-year old woman who came to our attention for severe anemia in a known history of genitourinary tract bleeding. Performing an ultrasound scan as a first-line exam it was discovered a large abdominal mass, at first described as a uterine neoformation. Only an MRI allowed to determine the hepatic nature of the mass and, after the resection, the histopathologic analysis confirmed the diagnosis of highly differentiated hepatocellular carcinoma arising in the context of marked steatosis.