Two Cases of Metastatic Intraabdominal Solitary Tumor after Resection of Hepatocellular Carcinoma

Mikiko Ueda, Kichiroh Taki, Takashi Takayasu, Iwao Ikai, Keiichi Ino, Keiichiro Mori, Yasuyuki Shimahara, Yoshio Yamaoka, Kazue Ozawa, Toshio Yamamoto*, Kazuyoshi Wada**

Second Department of Surgery, Kyoto University Medical School
*Kyoto National Hospital
**Wada Hospital

Two cases of an intraabdominal solitary tumor of hepatocelllular carcinoma are reported. In case 1, hepatocellular carcinoma with liver cirrhosis was resected. Two years later, multiple recurrent tumors occurred in the remnant liver with an increase in serum α-fetoprotein (AFP) which were treated by transcatheter arterial embolization. However, a child's-head sized tumor developed in the right hypochondrial region, accompanied by a markedly increase in AFP (36,200 ng/ml). This tumor was resected along with the greater omentum. In case 2, a ruptured hepatocellular carcinoma was treated by lateral segmentectomy of the liver, resulting in a decrease in the serum AFP level. Two and a half years later an increased serum AFP level led to the discovery of an abdominal tumor in the right lower quadrant, which was successfully resected along with the right hemicolon and the abdominal wall. Histologically both specimens were diagnosed as hepatocellular carcinoma. AFP levels were markedly decreased after the operations. Patient 1 and Patient 2 died of liver insufficiency due to recurrent hepatocellular carcinoma in the remnant liver, 4 years and 3 months, and 4 years and 8 months after the first operation, respectively.

Key words
hepatocellular carcinoma, metastatic intraabdominal tumor

Reprint requests
Mikiko Ueda Second Department of Surgery, Kyoto University Medical School
54-Kawara-cho, Shogoin, Sakyo-ku, Kyoto, 606 JAPAN

Accepted
November 11, 1992

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