Effective resection of a hepatocellular carcinoma that metastasized to the rectus abdominis muscle in a hemodialysis patient.

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We report a hemodialysis patient with hepatocelullar carcinoma (HCC) that metastasized to the rectus abdominis muscle. A 45-year-old male was admitted to our hospital because of an abdominal mass. Five years before admission, maintenance hemodialysis treatment was started because of end-stage renal failure of unknown etiology. Twenty months before admission, he was diagnosed as having HCC, and was treated with both arterial administration of SMANCS with lipiodol and percutaneous ethanol injection (PEI). Although serum α-fetoprotein (AFP) level was normalized after the treatment, it began to increase again gradually 4 months after the administration. Computed tomography (CT) of the liver revealed no evidence of recurrence of HCC. One month before admission. CT scan of the abdomen revealed a tumor in the rectus abdominis muscle. The tumor was surgically resected and histologically diagnosed as an HCC (moderately differentiated type). There are several reports of patients with neoplastic seeding along the needle track used to carry out PEI. In this case, however, the insertion site of the needle was about 20cm distant from the metastatic tumor in the rectus abdominis muscle. We conclude that this was a very rare case of HCC metastasized to the rectus abdominis muscle.
社団法人日本透析医学会の論文