Long-term survival in a patient with ruptured hepatocellular carcinoma.
A 57-yr-old woman previously diagnosed with chronic hepatitis B was admitted via the emergency room because she suddenly developed epigastric pain with abdominal distension. On computed tomography (CT), a round enhancing mass was found on the left hepatic lobe with ascites in the peritoneal space. Bloody ascites were found upon tapping the ascites, and this led to the diagnosis of ruptured hepatocellular carcinoma (HCC). The patient was immediately treated with transcatheter arterial chemoembolization (TACE) including 50 mg of adriamycin and 10 mL of lipiodol, and then we performed left lateral segmentectomy 20 days later. To prevent recurrence of HCC by any micrometastasis, the patient subsequently received 8 cycles of adjuvant systemic chemotherapy (a regimen of epirubicin (50 mg/m(2)), cisplatin (60 mg/m(2)) and 5-fluorouracil (200 mg/m(2))) at monthly intervals. After this, the patient has been regularly followed up and she shows no signs of tumor recurrence 7 years later. This case suggests that surgical resection and subsequent adjuvant systemic chemotherapy with using an ECF regimen may provide long-term survival for patients ruptured HCC.
Kim
Joon Sung
JS
Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.
Yoon
Seung Kew
SK
Kim
Jeong Ah
JA
Kim
Chang Wook
CW
Bae
Si Hyun
SH
Choi
Jong Young
JY
Jung
Chan Kwon
CK
D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000628:therapy; D008875:Middle Aged; D012422:Rupture, Spontaneous; D013997:Time Factors; D014057:Tomography, X-Ray Computed