A Case of Peritoneal Dissemination of Hepatocellular Carcinoma after Repeated Medical Therapies and Partial Hepatectomy.

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A 57-year-old man had been followed up for hepatocellular carcinoma in S2 and S6 since May 2001. He had received several sessions of radiofrequency ablation(RFA)and transcatheter arterial chemoembolization(TACE)till 2009. He underwent S6 partial hepatectomy for hepatocellular carcinoma in January 2010. When seen for right lower abdominal pain in December 2010, abdominal CT revealed a tumor 10 cm in diameter in the ileocecal region. We suspected abdominal recurrence of hepatocellular carcinoma because of a rise in the PIVKA-Ⅱ level, and performed extirpation of the tumor with appendectomy. Although macroscopically the tumor adhered to the posterior wall of the ileocecal region, histopathologically the wall of the appendix was intact. Six months later there was a subsequent episode of ileus, and abdominal CT revealed a new tumor measuring 7.5 cm on the lateral side of the descending colon. As enhanced CT in the arterial early phase also revealed several nodules, we diagnosed extensive dissemination of hepatocellular carcinoma. We report this rare case of peritoneal dissemination of hepatocellular carcinoma after repeated RFA/TACE treatment and partial hepatectomy along with a review of the literature.
山口大学医学会の論文