Resection of Peritoneal Implantation of Hepatocellular Carcinoma after Hepatic Resection: A Case Report / 한국간담췌외과학회지

ABSTRACT

Recent advances in the early diagnosis and curative resection of hepatocellular carcinoma (HCC) have improved its prognosis. However, there is controversy concerning aggressive surgical treatment of tumor recurrence after surgical resection for prolonging survival in some patients, and especially for the extrahepatic peritoneal implantation of tumor. We report here on one patient with hepatocellular carcinoma who experienced an implanted metastases in the abdominal cavity after hepatectomy. A 57-year-old man who had previously had a left lateral segmentectomy for a huge HCC with liver cirrhosis 14 months ago revisited the hospital due to the occurrence of a lower abdominal mass. On the initial work up, the alphafetoprotein (AFP) levels were increased and the abdominal tumor was visible at the ileocecal area, but intrahepatic recurrence was not visible in the remnant liver on abdominal computed tomography (CT). Therefore, peritoneal metastatic tumor resection with exploration of the other abdominal organs, and especially the remnant liver, were performed. After the second operation, the patient's postoperative course was uneventful and his serum AFP levels returned to the normal range at that time. Generally, surgical resection for intraabdominal implanted tumors is not indicated for improving survival, but resection of a local peritoneal implanted tumor arising from HCC may be of value for improving patient survival.