title: A long-term survivor undergoing extensive microwave coagulation for unresectable hepatocellular carcinoma.
abstract: Surgery for advanced hepatocellular carcinomas (HCCs) has not been standardized. We report on a long-term tumor-free survivor who underwent extensive microwave coagulation therapy (MCT) for multiple bilobar HCCs. A 61 year-old woman was diagnosed to have bilobar HCCs, including a large tumor, 9 cm in diameter, and 4 small satellite nodules, associated with chronic hepatitis B. The patient had received repeated chemoembolizations using iodized oil, but the increased alpha-fetoprotein level did not fall to normal. The main tumor was unresectable because the tumor involved the caval vein and hepatic veins. The patient underwent extensive MCT with a total of 134 electrode insertions. The paracaval portion of the main tumor was meticulously coagulated under sonographic guidance to avoid vascular injury. The post-operative course was uneventful. Post-operative computed tomography (CT) showed complete necrosis of all tumors. The patient is alive without tumor recurrence for 4 years after MCT. This case proves that extensive MCT can provide a chance of cure in selected patients with multiple bilobar HCCs and centrally located HCCs near the caval vein.
authors.affiliation: Department of Surgery II, Ehime University School of Medicine, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Sato
authors.forename: Y
authors.initials: Y
authors.lastname: Watanabe
authors.forename: K
authors.initials: K
authors.lastname: Tokui
authors.forename: M
authors.initials: M
authors.lastname: Murakami
authors.forename: T
authors.initials: T
authors.lastname: Kohtani
authors.forename: K
authors.initials: K
authors.lastname: Kawachi
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D000792:Angiography; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D003972:Diathermy / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D008872:Microwaves / Q000627:therapeutic use*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D014057:Tomography, X-Ray Computed; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D000509:alpha-Fetoproteins; D000410:Alanine Transaminase