Rapid Progression of Portal Vein Tumor Thrombus after Percutaneous Radiofrequency Ablation for Hepatocellular Carcinoma

Junko Izai, Hideyuki Kanemoto, Kazuya Matsunaga, Tomoki Ebata, Atsuyuki Maeda, Katsuhiko Uesaka, Hiroyoshi Furukawa¹⁾, Naoki Morimoto¹⁾ and Ichiro Ito²⁾

Department of Hepato-Biliary-Pancreatic Surgery, Department of Diagnostic Radiology¹⁾ and Department of Pathology²⁾, Shizuoka Cancer Center Hospital

A 71-year-old man with hepatocellular carcinoma (HCC) and chronic hepatitis C underwent percutaneous radiofrequency ablation therapy (RFA) for two HCC nodules 2 cm in diameter, in the anterior inferior segment (S5) and posterior inferior segment (S6) in March 2003. A tumor thrombus was detected in the right posterior inferior portal branch (P6) by US 38 days after RFA, which rapidly progressed and reached the anterior-posterior portal bifurcation one month later. He underwent right hepatic lobectomy in June 2003. Pathological examination showed the tumor thrombus to be moderately differentiated hepatocellular carcioma, whereas primary tumors in S5 and S6 were completely necrotic. Necrotic HCC in the portal venule was also detected in the ablated area of S6. We concluded that microscopic portal vein tumor thrombus may have been pushed into P6 by RFA, meaning RFA should be closely followed up taking into account possible rapid recurrence.

Key words
radiofrequency ablation, hepatocellular carcioma, portal tumor thrombus

Reprint requests
Junko Izai Department of Surgery, Saka General Hospital
16-5 Nishiki-cho, Shiogama, 985-0024 JAPAN

Accepted
February 23, 2005

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