Recurrent hepatocellular carcinoma with rapid growth after cardiac surgery.
A 65-year-old man diagnosed with hepatitis C virus-positive hepatitis and severe valvular heart disease was scheduled to undergo cardiac valve replacement. We then found hepatocellular carcinoma in the liver. Because of his severe cardiac dysfunction, we treated him surgically with radiofrequency ablation for the hepatocellular carcinoma only. We continued medical treatment of the heart disease. He hoped to undergo with cardiac surgery one year later for the cardiac dysfunction. There was no evidence of tumor recurrence. We informed him that cardiac surgery requiring extracorporeal circulation might lead to tumor recurrence. He agreed to cardiac valve replacement, and the surgery was successful. Recurrent hepatocellular carcinoma was found in the liver 1 month after the surgery. Over the next month, the tumor progressed rapidly, showing portal vein thrombi. We believe the use of extracorporeal circulation in particular triggered the rapid growth of the recurrent hepatocellular carcinoma. This is the first report of a recurrent hepatocellular carcinoma associated with hepatitis C virus that progressed extensively after cardiac surgery.
Shimizu
Hideyuki
H
Second Department of Internal Medicine, Nagoya University School of Medicine, Japan. simiz@med.nagoya-u.ac.jp
Katano
Yoshiaki
Y
Nagano
Kenichi
K
Yokozaki
Shoichi
S
Shimizu
Fukiko
F
Naito
Takehito
T
Hayashi
Kazuhiko
K
Shimizu
Yuko
Y
Honda
Takashi
T
Kaneko
Tetsuya
T
Akita
Shinji
S
Nakano
Isao
I
Fukuda
Yoshihide
Y
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000601:surgery / Q000821:virology; D017115:Catheter Ablation / Q000009:adverse effects* / Q000379:methods; D018450:Disease Progression; D017809:Fatal Outcome; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D019698:Hepatitis C, Chronic / Q000175:diagnosis; D006801:Humans; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery / Q000821:virology; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000503:physiopathology