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Pathological autopsy revealed moderately to poorly differentiated HCC without evidence of fibrolamellar carcinoma, which is common in young patients with HCC. Based on his history of obesity and fatty liver, we presumed that he had metabolic dysfunction-associated steatohepatitis. However, his non-neoplastic liver was normal. The HCC might have developed from metabolic dysfunction-associated steatotic liver disease, followed by regression of the underlying hepatic steatosis as the patient lost weight owing to HCC progression.<\/jats:p>","DOI":"10.1136\/bcr-2024-262841","type":"journal-article","created":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T12:25:24Z","timestamp":1734697524000},"page":"e262841","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Ruptured hepatocellular carcinoma developed in a normal liver in a young patient with a body mass index of 33 kg\/m<sup>2<\/sup>"],"prefix":"10.1136","volume":"17","author":[{"given":"Naoki","family":"Kirihata","sequence":"first","affiliation":[{"name":"Gastroenterology, National Hospital Organisation Kyoto Medical Center, Kyoto, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0157-0385","authenticated-orcid":false,"given":"Yoshiko","family":"Nakano","sequence":"additional","affiliation":[{"name":"Gastroenterology, National Hospital Organisation Kyoto Medical Center, Kyoto, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koki","family":"Moriyoshi","sequence":"additional","affiliation":[{"name":"Diagnostic Pathology, National Hospital Organisation Kyoto Medical Center, Kyoto, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2298-0970","authenticated-orcid":false,"given":"Shin'ichi","family":"Miyamoto","sequence":"additional","affiliation":[{"name":"Gastroenterology, National Hospital Organisation Kyoto Medical Center, Kyoto, Kyoto, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,12,20]]},"reference":[{"key":"2025082702355808000_17.12.e262841.1","unstructured":"Cancer Statistics . 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