A Case Report of Hepatocellular Carcinoma with Sarcomatous Change that Rapidly Recurred to the Abdominal Wall after the Operation

Hiroyuki Mushiake, Yuichi Kobashi, Shuichi Nomura, Masahiro Fujioka, Yoshiyuki Usui, Sumiji Sasaki

Department of Surgery, National Okayama Hospital

A case of hepatocelluar carcinoma with sarcomatous change that rapidly recurred in the abdominal wall and caused carcinomatous peritonitis after the operation is reported. A 64-year-old man was referred to our hospital because of a liver mass with epigastralgia. The tumor was similar to cholangiocellular carcinoma, metastatic liver tumor, liver abscess and hepatic cyst-adenoma (or adenocarcinoma) at the point of avascularity shown by contrast enhanced computed tomography and abdominal angiography. Under the intra-operative frozen pathological diagnosis of hepatocellular carcinoma, lateral segmentectomy of the liver with lymph node dissection was performed. The specimen revealed hepatocellular carcinoma with sarcomatous change and retropyloric lymph node metastasis. On post-operation day 41, recurrence in the abdominal wall was revealed, and peritoneal dissemination was revealed at resection of the recurrent abdominal wall tumor. The patient died 87 days after the first operation. Hepatocellular carcinoma with sarcomatous change has invasive growth, a high incidence of extrahepatic metastasis and a rapid clinical course. If hepatocellular carcinoma with sarcomatous change is suspected, hepatectomy with a sufficient surgical margin and wide lymph node dissection in the early stage are necessary. This is the eighth operative case of hepatocellular carcinoma with sarcomatous change in Japan.

Key words
hepatocellular carcinoma, sarcomatous change, lymph node metastasis of hepatocellular carcinoma

Reprint requests
Hiroyuki Mushiake Department of Surgery II, Okayama University Medical School
2-5-1 Shikata-cho, Okayama-city, 700-8558 JAPAN

Accepted
June 10, 1998

To read the PDF file you will need Abobe Reader installed on your computer.