Hepatocellular Carcinoma Metastasis to the Umbilicus

Yutaka Ozeki, Naomasa Yoshida, Michiya Bando, Kimi Yamauchi, Takuya Yamada and Yasuhiro Sumi

Department of Surgery, Tosei National Hospital

A 74-year-old woman was admitted to our hospital because of chest pain. Ultrasonography revealed a 16 cm hepatocellular carcinoma (HCC) in the lateral segment of the liver. Lateral segmentectomy, partial resection of the stomach and left diaphragm, and splenectomy were performed. Histologically, a poorly differentiated HCC was proven and HCC was also demonstrated in the ascitic fluid removed during operation. Although her postoperative course was uneventful, a 2 cm mass of the umbilicus emerged on the 23rd postoperative day (POD). On the 36th POD, the umbilicus was resected and peritoneal dissemination was disclosed during operation. The resected umbilicus consisted of a poorly differentiated HCC and vascular invasion was detected. Therefore, hematogeneous metastasis was indicated. She died of respiratory failure due to left pleural dissemination 2 months after the hepatectomy. To our knowledge, there are no other reported cases of HCC which are metastatic to the umbilicus.

Key words
hepatocellular carcinoma, metastatic carcinoma of the umbilicus, Sister Mary Joseph's nodule

Reprint requests
Yutaka Ozeki Department of Surgery, Tosei National Hospital 762-1 Nagasawa, Shimizu-cho, Sunto-gun, Shizuoka, 411-8611 JAPAN

Accepted
April 28, 1999

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