A Case-Based Review of Advanced Surgical Techniques in the Treatment of Incidentally Diagnosed Fibrolamellar Hepatocellular Carcinoma

Fibrolamellar hepatocellular carcinoma (FL-HCC) is a rare liver tumor that typically affects young adults without underlying liver disease. This case describes an incidental diagnosis of FL-HCC in a healthy 25-year-old male who presented to the Emergency Department with left flank pain. Imaging revealed a ureteropelvic junction stone with moderate hydronephrosis, as well as an unexpectedly large right hepatic mass. Further evaluation confirmed the diagnosis of FL-HCC. The patient underwent a successful right hepatectomy utilizing the anterior approach with hanging maneuver and extra-Glissonian right pedicle control. Postoperatively, the patient experienced an uneventful recovery. This case highlights the importance of thorough evaluation of incidental findings, even in asymptomatic and healthy individuals, and demonstrates the advantages of advanced surgical techniques in managing large liver tumors.