Mounica Konjeti, MD; Jessica Musto, MD
WMJ. 2026;125(4):529-532. Published November 1, 2026.
ABSTRACT
Introduction: Fibrolamellar carcinoma (FLC) is a rare variant of hepatocellular carcinoma (HCC) that affects people without underlying cirrhosis. The association between HCC and inflammatory bowel disease has been reported in patients with ulcerative colitis.
Case Presentation: A 23-year-old woman with newly diagnosed Crohn disease was incidentally found to have a large hepatic mass during evaluation of gastrointestinal symptoms. Imaging findings were concerning for HCC. Pathology after surgical resection revealed fibrolamellar variant of HCC. The patient developed recurrent FLC and underwent a portal lymphadenectomy and resection of a portal mass. She was started on lenvatinib and has remained in remission.
Discussion: Reports of HCC in patients with IBD are limited, and previously reported cases of FLC have occurred exclusively in patients with ulcerative colitis. We describe a case of FLC in a patient newly diagnosed with Crohn’s disease. Although curative resection is possible, 50% to 100% of patients experience relapse and recurrence.
Conclusions: This case highlights the characteristic clinical, radiographic, histopathologic, and molecular features of FLC and expands the limited literature on the association between FLC and IBD.