Fibrolamellar hepatocellular carcinoma (FLHCC) is a rare malignant
liver neoplasm, commonly observed in adolescents and young adults of both genders. The disease is more common in Caucasians and in patients without a prior history of
liver disease. The best treatment option is a surgical resection associated with liver hilum
lymph node dissection. However, there is no established systemic
drug treatment for patients with locally advanced or metastatic disease. We report on a patient with advanced FLHCC, initially considered unresectable due to invasion of the right and the middle hepatic veins and circumferential involvement of the left hepatic vein. Following the treatment with
gemcitabine-
oxaliplatin systemic
chemotherapy, the patient exhibited a significant
tumor reduction. As a result, a complete resection was performed with an extended right
hepatectomy associated with a partial resection of the inferior vena cava, a wedge resection in segment 2, and
lymphadenectomy of the hepatic hilum. The case was unusual due to the significant
tumor downstaging with
gemcitabine-
oxaliplatin, potentially enabling curative resection. More studies are needed to confirm the efficacy of the systemic
drug treatment for FLHCC.