title: Splenic metastasis of hepatocellular carcinoma.
abstract: A 76-year-old man, who underwent central bisegmentectomy of the liver, transcatheter arterial chemoembolization, and radiofrequency ablation for chronic hepatitis C virus-related hepatocellular carcinoma (HCC), was found to have a 3 cm mass in the spleen and a 2 cm mass in the liver by computed tomography in January 2003. As both tumors were adjacent, a diagnosis of HCC with splenic infiltration was made. In February 2003, transcatheter arterial chemoembolization and splenic arterial chemo-infusion were performed. However, the splenic tumor increased to 5 cm with slight enhancement on contrast-enhanced computed tomography performed 6 months later, while the hepatic tumor had no enhancement. Limited resection of the liver with splenectomy was performed in October 2003. Macroscopically, the splenic tumor showed infiltrative growth without a capsule while the hepatic tumor showed complete necrosis within its capsule. The splenic tumor was limited to the splenic parenchyma. Histologic examination revealed that the splenic tumor was poorly differentiated HCC, leading to the diagnosis of splenic metastasis. The patient is doing well 17 months after surgery without recurrence. One should perform surgery for splenic metastasis of HCC without hesitation whenever possible.
authors.affiliation: Department of Hepato-Billiary-Pancreatic Surgery, Osaka City University, Graduate School of Medicine, 1-4-3, Asahimachi, Abeno-ku, Osaka 545-8585, Japan. iamhiro21@yahoo.co.jp
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Hayashi
authors.forename: Shogo
authors.initials: S
authors.lastname: Tanaka
authors.forename: Taichi
authors.initials: T
authors.lastname: Shuto
authors.forename: Hiromu
authors.initials: H
authors.lastname: Tanaka
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Takemura
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hirohashi
authors.forename: Shoji
authors.initials: S
authors.lastname: Kubo
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D013160:Splenic Neoplasms / Q000556:secondary*