title: A 5-year survivor after resection of peritoneal metastases from pedunculated-type hepatocellular carcinoma.
abstract: We report herein a 5-year survivor after the resection of peritoneal metastases from pedunculated hepatocellular carcinoma (HCC). A 42-year-old man underwent lateral segmentectomy of the liver, with a diagnosis of pedunculated HCC, on October 10, 1994. The lesion was associated with intratumoral hemorrhage and was covered by the greater omentum, but there were no peritoneal metastases. The patient was readmitted to our hospital 4 months later with right upper quadrant pain. His serum alpha-fetoprotein level was 3ng/dl. Hepatitis B virus surface antigen (HBsAg) and hepatitis C virus antibody (HCV-Ab) were both negative. Abdominal computed tomography (CT) revealed two nodular lesions in the right upper abdominal cavity. He was diagnosed with peritoneal metastases from HCC. Because there were no other distant metastases, laparotomy was performed to resect these tumors. We found two other tumors, located in the mesentery of the appendix and ileum. All four tumors were resected by partial transverse colectomy and appendectomy. The histopathology of the tumors showed poorly differentiated HCC (Edmondson-Steiner's grade III). The patient has been doing well without recurrent disease for more than 5 years after the second operation. The prognosis of patients with pedunculated HCC is poor. Furthermore, resection for peritoneal metastases from HCC is rare because of the presence of multiple seeding in the abdominal cavity and distant organ metastases. To our knowledge, our patient is the longest survivor after resection of peritoneal metastases from pedunculated HCC.
authors.affiliation: Second Department of Surgery, Hamamatsu University School of Medicine, Handayama, Japan.
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Kurachi
authors.forename: Shohachi
authors.initials: S
authors.lastname: Suzuki
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Yokoi
authors.forename: Takuya
authors.initials: T
authors.lastname: Okumura
authors.forename: Keisuke
authors.initials: K
authors.lastname: Inaba
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Igarashi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Takehara
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Konno
authors.forename: Satoshi
authors.initials: S
authors.lastname: Baba
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nakamura
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology*; D008297:Male; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D016019:Survival Analysis; D013997:Time Factors