Refractory Hyperammonemic Encephalopathy as a Paraneoplastic Presentation of Fibrolamellar Hepatocellular Carcinoma: A Case Report

Ritwik Dey; Harshitha Popuri; Virali Gulla; Yagnapriya Chirrareddy; Satyapriya Paritala; Daniel Bustamante; Javier Corral

doi:10.12659/AJCR.952819

24 August 2026 : Case report USA

Refractory Hyperammonemic Encephalopathy as a Paraneoplastic Presentation of Fibrolamellar Hepatocellular Carcinoma: A Case Report

Management of emergency care, Rare disease

Ritwik Dey

^{ABDEF 1*}, Harshitha Popuri^{ABDEF 1}, Virali Gulla^{BDEF 1}, Yagnapriya Chirrareddy

^{EF 1}, Satyapriya Paritala^{EF 1}, Daniel Bustamante

^{ABDE 2}, Javier Corral^{ABDEF 3}

DOI: 10.12659/AJCR.952819

Am J Case Rep 2026; 27:e952819

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Figure 1 Biopsy from liver mass showing large pleomorphic neoplastic polygonal cells with abundant eosinophilic cytoplasm, nuclear inclusions, and prominent nucleoli arranged in nests and sheets, separated by collagenous fibrous bands characteristic of fibrolamellar hepatocellular carcinoma.

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Refractory Hyperammonemic Encephalopathy as a Paraneoplastic Presentation of Fibrolamellar Hepatocellular Carcinoma: A Case Report

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