A Case of Long-term Survival following Peritoneal Dissemination of Hepatocellular Carcinoma after a Hepatectomy performed 8 Years previously

Takashi Shiroko¹⁾, Naoki Yokoo¹⁾, Yasuhito Kitakado¹⁾, Manabu Futamura²⁾, Shigeru Mori²⁾, Takami Fukui²⁾ and Kiyohisa Okamoto³⁾

Departments of Surgery¹⁾ and Pathology³⁾, Takayama Red Cross Hospital
Second Department of Surgery, Gifu University School of Medicine²⁾

Peritoneal dissemination of hepatocellular carcinoma (HCC) is rare, and its prognosis is extremely poor. A case of long-term survival after postoperative adjuvant immuno-chemotherapy for peritoneal dissemination of HCC and the autopsy findings are reported. A 71-year-old woman who underwent a lateral segmentectomy for HCC in 1989, and a medial segmentectomy for an HCC recurrence in 1996 was admitted to our hospital after she identifed tumor in her abdomen. Fine needle aspiration cytology was performed, and peritoneal recurrence of HCC was suspected. A laparotomy was performed, and ascites and several metastatic nodules were identified in the greater omentum and mesenterium. The metastatic nodules were suspected to have arisen from the peritoneal dissemination of HCC. An intraperitoneal infusion of Mitomycin C via an intraperitoneal reservoir was given for about one year, and the prescription of UFT and PSK was continued until the last admission. Although the patient died 30 months after her 3rd operation, she was able to be treated on an outpatient basis and maintain a good quality of life for more than 27 months. No intrahepatic metastases or indications of a progressive disseminated tumor were found at the time of autopsy. This may suggest that it is possible to live for a long term under a good quality of life by a reduction surgery of tumors and adjuvant chemotherapy, even if peritoneal dissemination has arisen from HCC.

Key words
hepatocellular carcinoma, peritoneal dissemination, adjuvant immuno-chemotherapy

Reprint requests
Takashi Shiroko Department of Surgery, Takayama Red Cross Hospital 3-11 Tenman-cho, Takayama City, 506-8550 JAPAN

Accepted
September 20, 2000

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