Successful Resection of Hepatocellular Carcinoma Associated with Stage II Primary Biliary Cirrhosis

Junichi Yamanaka and Jiro Fujimoto

First Department of Surgery, Hyogo College of Medicine

There have been a few reports of hepatocellular carcinoma (HCC) in cases with primary biliary cirrhosis (PBC). In particular, resection of HCC in PBC patients has been rarely reported. We report a case of HCC in a 79-year-old male patient with stage-II PBC, in whom successful curative liver resection was performed. Preoperative abdominal CT revealed a heterogeneously enhancing tumor, 13 cm in diameter, occupying the left lateral sector. Serum tumor markers including alpha-fetoprotein and des-gamma-carboxy prothrombin were elevated. The patient was diagnosed as having HCC and underwent resection of the left lateral sector in March 2004. Microscopic examination of the resected left lateral sector revealed moderately differentiated HCC, and a tumor-free area showing evidence of stage-II PBC. There have been nine reported cases of resected HCC associated with PBC. Eight of the nine patients were alive more than one year postoperatively. The patient in this report is alive and well without recurrence until now, 28 months after the surgery. Early detection of HCC by close follow-up of patients with PBC may facilitate curative tumor resection and lead to improved survival.

Key words
biliary cirrhosis, liver cancer, hepatectomy

Reprint requests
Junichi Yamanaka First Department of Surgery, Hyogo College of Medicine
1-1 Mukogawa-cho, Nishinomiya, 663-8501 JAPAN

Accepted
October 25, 2006

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