[A case of hepatocellular carcinoma (acute abdominal type) misdiagnosed as acute appendicitis and satisfactorily treated by a two-stage operation].
A 66-year-old man was admitted because of right lower abdominal pain and was operated on for acute appendicitis on March 12, 1983. It was found that his appendix was not inflamed, but a bleeding tumor was encountered in the posterior segment of the liver. Bleeding was controlled by suturing the liver above the tumor. Postoperative celiac angiography revealed many daughter tumors scattered in, but restricted to, the right lobe of the liver. The patient was treated by transcatheter arterial embolization combined with transcatheter arterial infusion of lipiodol and Adriamycin on April 25. Subsequently, a curative operation (right hemihepatectomy) was performed on May 24. The patient is still alive without recurrence 6 months after the resection. In case of ruptured hepatocellular carcinoma, it appears to be better to perform a two-stage operation with careful estimation of functional reserve of the liver, and to conduct transcatheter arterial embolization between operations to prevent the growth of the tumor during that period.
D000006:Abdomen, Acute / Q000175:diagnosis; D000208:Acute Disease; D000368:Aged; D001064:Appendicitis / Q000175:diagnosis*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D004317:Doxorubicin / Q000008:administration & dosage; D004621:Embolization, Therapeutic; D005781:Gelatin Sponge, Absorbable / Q000008:administration & dosage; D006499:Hepatic Artery; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D008297:Male; D012422:Rupture, Spontaneous
D004317:Doxorubicin