A Case of Extrahepatic-Growing Hepatocellular Carcinoma who Survived More than 5 Years without Recurrence, after Resection of Solitary Intrahepatic Metastasis which was Detected 18 Months after the Primary Resection

Masanori Matsuda, Hideki Fujii, Masatoshi Mogaki and Yoshiro Matsumoto

First Department of Surgery, Yamanashi Medical University

A 57-year-old woman, who was negative for HBsAg and HCV-Ab, underwent lateral segmentectomy of the liver with a diagnosis of extrahepatic-growing hepatocellular carcinoma (HCC), 6.5 cm in diameter, which was connected to the lateral segment of the liver by a thin stalk, in July 1992. Histological diagnosis of the tumor was moderately to poorly differentiated HCC with cancer cell invasion of the portal vein in the stalk of the tumor. There was no tumor in other parts of the liver. Eighteen months after operation, computed tomography (CT) revealed a single nodular tumor, 0.6 cm in diameter, in the medial segment of the liver. In March 1994, partial resection of the medial segment of the liver was performed. Histologically, the recurrent tumor was moderately to poorly differentiated HCC which was similar to the primary tumor, so the diagnosis of this recurrent tumor was metachronous appearing intrahepatic metastasis. She survived more than 5 years without recurrence after the second operation. Clinical course of this patient indicated that even though the HCC shows pedunculated type, systemic hepatic resection should be indicated for curative resection.

Key words
repeat hepatic resection, extrahepatic-growing hepatocellular carcinoma, intrahepatic metastasis

Reprint requests
Masanori Matsuda First Department of Surgery, Yamanashi Medical University Tamaho-machi, Nakakoma-gunn, Yamanashi, 409-3898 JAPAN

Accepted
September 22, 1999

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