A Case Report of Surgically Removed Hepatocellular Carcinoma with Metastasis to the Rib and the Lymph Node, after Performing Percutaneous Transhepatic Portal Vein Embolization

Hisao Wakabayashi, Koutaro Matushita, Isao Hamamoto, Setsuo Okada, Takashi Maeba, Hajime Maeta, Satoshi Tanaka

First Department of Surgery, Kagawa Medical School

A case of hepatocellular carcinoma is reported here, in which hepatectomy including resections of a metastasis to the 11th rib and the gastric lymph node was performed after increasing the remnant liver volume by embolizing the right branch of the portal vein. The patient was a 59-year-old man. The hepatocellular carcinoma, which had tumor thrombuses in the anterior segment branch of the portal vein and middle hepatic vein, was found to have metastasis to the rib. As no other metastasis was found on clinical examinations, surgical resection was considered. However, liver function was evaluated to be insufficient, when extended right lobectomy or right trisegmentectomy was considered. Therefore, extended right lobectomy was performed, after the remnant liver volume had been increased by percutaneous transhepatic portal vein embolization (PTPE). In the operation a metastasis of the gastric lymph node was found and resected The post-operative course was satisfactory, and the patient is alive over 1 year after the operation without any evidence of reccurence. It was thought that even in advanced cases of hepatocellular carcinoma, positive surgical resection may make it possible for patients to obtain a better prognosis.

Key words
hepatocellular carcinoma, metastasis of hepatocellular carcinoma, percutaneous transhe patic portal vein embolization

Reprint requests
Hisao Wakabayashi First Department of Surgery, Kagawa Medical School
Miki-cho, Kita-gun, Kagawa, 761-07 JAPAN

Accepted
October 12, 1994

To read the PDF file you will need Abobe Reader installed on your computer.