RESUMO
Recent advances in multi-detector row computed tomography have enabled the synthesis of high-quality multiplanar reconstruction images. With this technique, arbitrary sectional images resembling conventional ultrasonography (US) images, i.e. virtual US images, can easily be created. We describe 3 cases of small hepatocellular carcinoma poorly visualized with US in which US-guided percutaneous ablation was safely and successfully performed with the assistance of the virtual US system. No local recurrence was found after a mean follow-up of 17 months. Percutaneous ablation using the virtual US system is a promising method for treating hepatocellular carcinoma poorly visualized with US.
Assuntos
Carcinoma Hepatocelular/cirurgia , Neoplasias Hepáticas/cirurgia , Cirurgia Assistida por Computador , Idoso , Carcinoma Hepatocelular/diagnóstico por imagem , Feminino , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Masculino , Tomografia Computadorizada por Raios X/métodos , Ultrassonografia/métodosRESUMO
A 79-year-old female patient with hepatitis C virus-related liver cirrhosis was diagnosed as having hepatocellular carcinoma (HCC) with a diameter of 2.0 cm. She refused therapy for HCC. Nine months after the diagnosis, she developed dermatomyositis when the HCC enlarged to a diameter of 6.0 cm. She underwent therapy for dermatomyositis, and then transcatheter arterial chemoembolization for HCC. Although the manifestations of dermatomyositis improved and entire tumor necrosis was achieved, she died of pneumonia 2 mo after the treatment of HCC. HCC and/or chronic hepatitis C virus infection might be involved in the pathogenesis of dermatomyositis.
Assuntos
Carcinoma Hepatocelular/complicações , Dermatomiosite/etiologia , Hepatite C/complicações , Cirrose Hepática/complicações , Cirrose Hepática/virologia , Neoplasias Hepáticas/complicações , Idoso , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/terapia , Quimioembolização Terapêutica , Dermatomiosite/diagnóstico , Dermatomiosite/fisiopatologia , Feminino , Hepatite C/diagnóstico , Hepatite C/fisiopatologia , Humanos , Cirrose Hepática/patologia , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/terapiaRESUMO
A 43-mm hepatic tumor was incidentally detected by computed tomography in a 72-year-old man. Liver function test results were normal. Serum hepatitis B, C and G viruses were negative, while serum TT virus was positive. Autoantibodies were negative. The patient had no history of alcohol consumption. The tumor was found to be a moderately differentiated hepatocellular carcinoma (HCC) from a resected specimen. Neither lobular inflammation nor fibrosis was observed in the surrounding liver. Intrahepatic hepatitis B virus was not detected. This is a case of non-B, non-C HCC positive for only TT virus arising from a non-cirrhotic liver.
