A Case of Tumor Seeding after Percutaneous Radiofrequency Ablation for Hepatocellular Carcinoma

Masashi Hirota, Shin Takeda, Hiroyuki Sugimoto, Tetsuya Kaneko, Soichiro Inoue and Akimasa Nakao

Department of Surgery II, Nagoya University School of Medicine

We report a case of tumor seeding after percutaneous radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC). A 56-year-old woman who had previously undergone RFA with 2 insertions of a cooled-tip electrode to 28×20 mm subcapsular HCC in liver segment VII was found 9 months later in abdominal computed tomography to have a small, mild contrast-enhanced mass outside the hypodense area of the RFA, so partial hepatectomy was done based on a diagnosis of HCC recurrence. Macroscopically, 2 tumors measured 7×6 mm and 3×3 mm. Histopathologically, the 2 well-differentiated HCC tumors existed in a layer of fatty tissue near the completely necrosed tissue of the ablated area. The final diagnosis of tumor seeding was determined because no contact was seen between the 2 tumors, consistent with 2 insertions, and the ablated area. We are now studying how to manage the prevention of tumor seeding after RFA.

Key words
percutaneous radiofrequency ablation, hepatocellular carcinoma, tumor seeding

Reprint requests
Masashi Hirota Department of Surgery II, Nagoya University School of Medicine
65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 JAPAN

Accepted
December 19, 2003

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