Needle tract implantation of hepatocellular carcinoma after fine needle biopsy.
The reported incidence of needle tract implantation of hepatocellular carcinoma after fine needle biopsy ranges from 1 to 5%. We collected five cases of hepatocellular carcinoma with needle tract implantation after percutaneous biopsy and tried to determine how this complication affects the clinical outcome. From September 1997 to May 2002, five patients with needle tract implantation of hepatocellular carcinoma were managed in our institution. For treatment of the primary hepatocellular carcinoma, three patients underwent hepatectomy, one had transarterial chemoembolization, and in one patient peritoneal seeding in the needle tract precluded curative resection. All three hepatectomy patients were detected to have tumor implants in the needle tract at an interval of 39 to 58 months after biopsy. These implants were managed with wide surgical excision. Local control was achieved in two patients after repeat resection, whereas the third developed pulmonary metastasis. Thus, in two of five patients, tract implantation after fine needle biopsy changed a potentially curative disease into an untreatable situation. Because of the risk of tumor implantation in the needle tract, we support a policy of selective use of fine needle biopsy for the definitive diagnosis of liver lesions. The patients who do need a biopsy should be carefully followed up for early detection of implanted tumor and its recurrence after resection.
Liu
Yueh-Wei
YW
Department of Surgery and Liver Transplant Program, Chang Gung University, Chang Gung Memorial Hospital, Kaohsiung Medical Center 123, Ta-Pei Road, Niao-Sung, Kaohsiung 83301, Taiwan.
Chen
Chao-Long
CL
Chen
Yaw-Sen
YS
Wang
Chih-Chi
CC
Wang
Shih-Ho
SH
Lin
Chih-Che
CC
D000368:Aged; D044963:Biopsy, Fine-Needle / Q000009:adverse effects*; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009366:Neoplasm Seeding