Partial hepatectomy for hepatocellular carcinoma in a patient with hemophilia: a case report.
We describe successful partial hepatectomy for hepatocellular carcinoma (HCC) in a 43-year-old man with severe factor VIII deficiency (hemophilia A). Tumor size and plasma alpha-fetoprotein (AFP) decreased spontaneously prior to surgery. HCC was found in the anterior superior segment of the liver, with invasion of the diaphragm. A limited partial resection of the liver and diaphragm was performed. The administration of factor VIII during and immediately after surgery resulted in no postoperative bleeding complications. Macroscopic findings revealed hemorrhage and necrosis throughout the intrahepatic portion of the tumor. Viable HCC cells were recognized histologically in the intrahepatic tumor and infiltrating the diaphragm. In patients with hemophilia there is a tendency for HCC to hemorrhage, which may obscure the diagnosis. Appropriate administration of factor VIII permits the safe resection of HCC in hemophilia A.
Department of Surgery II, Nagoya University School of Medicine, Japan.
S C
SC
Shen
A
A
Harada
T
T
Kurokawa
A
A
Nakao
T
T
Nonami
K
K
Isobe
M
M
Imoto
J
J
Takamatsu
H
H
Takagi
D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D005169:Factor VIII / Q000008:administration & dosage*; D006467:Hemophilia A / Q000150:complications*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007430:Intraoperative Care; D008113:Liver Neoplasms / Q000150:complications / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D008297:Male; D009361:Neoplasm Invasiveness; D011182:Postoperative Care; D012720:Severity of Illness Index
D005169:Factor VIII