A Case of Extrahepatically Growing Hepatocellular Carcinoma Fed by the Right Middle Adrenal Artery

Tetsuya Kaneko, Keisuke Terabe, Koichi Ito, Koichi Fujita, Akimasa Nakao*

Department of Surgery, Shinshiro City Hospital
*The Second Department of Surgery, Nagoya University School of Medicine

A 45-year-old man was admitted to our hospital because of an abdominal injury. An abdominal tumor was found between the right lobe posterior segment of the liver and the right kidney. Angiography revealed the hypervascularity of the tumor. The extrahepatic portion was fed mainly by the right middle adrenal artery. The tumor was considered to be an extrahepatically growing hepatocellular carcinoma because of the high serum level of α-fetoprotein and positive HBs antigen. A right hepatic lobectomy was performed and the patient has been healthy for the more than 2 years since the operation. It is difficult to determine the origin of a tumor by the feeding artery only. In this case, the problem was differentiation from a nonfunctional adrenal medullary tumor. T2-weighted magnetic resonance imaging was useful in the differentiation. Sixty-seven cases of extrahepatically growing hepatocellular carcinoma have been repored in the Japanese literature. In Japanese and English literature this is considered to be the first case of the extrahepatically growing hepatocellular carcinoma fed by the right middle adrenal artery.

Key words
hepatocellular carcinoma with extrahepatic growth

Reprint requests
Tetsuya Kaneko Second Department of Surgery, Nagoya University School of Medicine
65 Tsuruma-cho, Showa-ku, Nagoya City, 466 JAPAN

Accepted
October 9, 1991

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