title: [Surgical treatment for peritoneal dissemination of hepatocellular carcinoma after percutaneous ethanol injection therapy--a case report].
abstract: We report a 73-year-old man who underwent surgery for peritoneal dissemination of hepatocellular carcinoma (HCC) after percutaneous ethanol injection therapy (PEIT). He received posterior segmentectomy for HCC in 1997. Four years after the first hepatic resection, a recurrence lesion in the right caudal lobe of the liver was detected by computed tomography (CT). He underwent percutaneous ethanol injection therapy (PEIT) and transcatheter arterial embolization (TAE). He was referred to our hospital for further treatment. Abdominal CT revealed an early-enhanced lesion (3.2 cm in size) in the right caudal lobe of the liver and an irregular mass lesion (1.5 cm in size) in the cranial. We diagnosed the disease as recurrent HCC and carried out partial hepatectomy, removal of peritoneal dissemination and a reconstruction of the inferior vena cava. A histological feature of the tumor was a moderately differentiated HCC, and there was no lymphatic structure in the tumor, and no connection to the residual liver. Therefore, we diagnosed the tumor as peritoneal dissemination of HCC. We think that this is a rare but a serious complication of PEIT and every effort should be attempted to prevent this complication, especially in the treatment of superficial and larger HCC.
authors.affiliation: Dept of Surgery, Graduate School of Medicine, Osaka University.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Wada
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagano
authors.forename: Takehiro
authors.initials: T
authors.lastname: Noda
authors.forename: Bazarragchaa
authors.initials: B
authors.lastname: Damdinsuren
authors.forename: Shigeru
authors.initials: S
authors.lastname: Marubashi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Miyamoto
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Takeda
authors.forename: Koji
authors.initials: K
authors.lastname: Umeshita
authors.forename: Keizo
authors.initials: K
authors.lastname: Dono
authors.forename: Kenichi
authors.initials: K
authors.lastname: Wakasa
authors.forename: Morito
authors.initials: M
authors.lastname: Monden
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects*; D004621:Embolization, Therapeutic; D000431:Ethanol / Q000008:administration & dosage; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D008297:Male; D009364:Neoplasm Recurrence, Local; D009366:Neoplasm Seeding; D010534:Peritoneal Neoplasms / Q000473:pathology*; D014057:Tomography, X-Ray Computed
chemical_list: D000431:Ethanol