title: A case of hepatocellular carcinoma with situs inversus totalis.
abstract: We report a case of hepatocellular carcinoma with situs inversus totalis treated by hepatectomy. A 70-year-old asymptomatic female with hepatocellular carcinomas in segments 5, 6 and 8 underwent transarterial embolization in the department of medicine. However, hepatocellular carcinoma in segment 8 relapsed, and she was referred to the department of surgery. Laboratory tests revealed elevation of serum PIVKA2 level (4,690 ng/mL). Angiography revealed tumor stain in segment 8, 3 cm in diameter. No aberrant vessels were detected on angiography. The operator stood on the patient's left, and partial hepatectomy could be performed safety after careful examination of the anatomy. Although aberrant vessels are detected in many patients with situs inversus totalis, operations can be performed safely on them with sufficient understanding of the anatomy.
authors.affiliation: Surgery for Organ Function and Biological Regulation, Nippon Medical School, Graduate School of Medicine.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kakinuma
authors.forename: Takashi
authors.initials: T
authors.lastname: Tajiri
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshida
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Mamada
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Taniai
authors.forename: Youichi
authors.initials: Y
authors.lastname: Kawano
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Mizuguchi
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Shimizu
authors.forename: Tsubasa
authors.initials: T
authors.lastname: Takahashi
authors.forename: Koho
authors.initials: K
authors.lastname: Akimaru
authors.forename: Takumi
authors.initials: T
authors.lastname: Aramaki
authors.forename: Teruo
authors.initials: T
authors.lastname: Takano
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000601:surgery*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000601:surgery*; D012857:Situs Inversus / Q000150:complications*; D016896:Treatment Outcome