Surgical removal of a distinct subcutaneous metastasis of multilocular hepatocellular carcinoma 2 months after initial percutaneous ethanol injection therapy.
Subcutaneous tumor seeding after percutaneous ethanol injection therapy (PEI) for hepatocellular carcinoma is a rarely seen complication. It is reported due to needle track seeding during PEI after a distance of 6-46 months. Metastatic tumor spread is described subcutaneously, to the chest wall, abdominal wall and diaphragm. We report the case of a 76-year-old patient with chronic hepatitis B infection and cirrhosis which let to a multilocular hepatocellular carcinoma who underwent PEI. This patient developed 2 months after primary PEI a subcutaneous tumor formation confined to the right lower chest wall. Surgical tumor resection was performed. The histopathological evaluation confirmed subcutaneous seeding of the preknown hepatocellular carcinoma with a maximum of 30 mm in diameter. As a risk of PEI subcutaneous metastasis of the primary tumor should be considered even in early stage of therapy and close follow-up of the patient during treatment is required. Surgical tumor resection to ensure the curative intention of PEI is advisable.
Braune
C
C
Orthopädische Universitätsklinik und Poliklinik Friedrichsheim Frankfurt am Main. C.Braune@em.uni-frankfurt.de
Widjaja
A
A
Bartels
M
M
Bleck
J S
JS
Flemming
P
P
Manns
M P
MP
Klempnauer
J
J
Gebel
M
M
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D062109:Dermatologic Surgical Procedures; D000431:Ethanol / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D008297:Male; D009366:Neoplasm Seeding; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery
D000431:Ethanol