Pedunculated Hepatoma ; A Clinical Study of 7 Cases

概要

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Pedunculated hepatoma (hepatocellular carcinoma ; HCC) showing an extrahepatic growth is very rare. In order to clarify the clinical and pathological features and problems presented by this tumor, seven patients in our hospitals were reviewed. All patients were men and the average age was 64 years. Tumors originated from the lateral segment in 3 patients, anterior segment in 2, and medial segment and quadrate lobe in one patient each, and ranged in size from 7 cm to 21 cm with pedicles (2-7 cm) corresponding to the liver tissue. Underlying liver disease was found in 6 patients ; cirrhosis and chronic hepatitis in 3 patients each. Initial symptoms were abdominal pain and palpable abdominal mass. Imaging modalities including US, CT and angiography could not adequately demonstrate definite findings of this tumor arising from the liver. Serum AFP was normal or slightly elevated in 3 patients. Pathologically, pedunculated tumors showed expansive growth with septum formation and complete capsule, with a portal vein thrombus and/or frequent satellite tumors. The postoperative outcomes of the 5 patients were excellent in only one patient. The other 4 patients died of hepatic recurrence of the tumor within 3 years. This study suggests that early detection of small pedunculated HCC and an adequate resection margin are the most important factors for the prognosis of patient.
長崎大学の論文