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Plain English summary of "Environmental Exposures as a Risk Factor for Fibrolamellar Carcinoma"

Pulbished in Modern Pathology, March, 2017

Searching for causes of fibrolamellar, researchers noticed a potentially important chronological clue: all identifications of fibrolamellar occurred after 1939, when World War II began. The researchers then went into the pathology archives at the Mayo Clinic, in Rochester, Minnesota, and analyzed the original slides of tissues created from surgeries that took place between 1905 and 1939. Further, they reviewed the patients' clinical charts and performed a variety of state-of-the-art tests (at the histologic, ultrastructural and proteomic levels) to confirm the diagnoses associated with the slides.

Using these methods, they were able to positively identify two cases of fibrolamellar, from 1915 and 1924.  The existence of these two cases from before WWII implies a "reduced likelihood" that exclusively post-WWII factors, such as the rise of the plastics industry, cause fibrolamellar. 

The authors report that their findings, along with the fact that fibrolamellar tumor cells have aryl hydrocarbon receptors on them, suggest the possibility that environmental exposures that are new since World War II may not be exclusively responsible for causing fibrolamellar.  However, they note that their findings do not exclude a role for other potential environmental risk factors. Nor does this work address the change in the frequency of fibrolamellar diagnoses before and after World War II.

--Rachael Migler, The Fibrolamellar Registry