title: Development of hepatocellular carcinoma in cardiac congestive liver fibrosis: report of a case.
abstract: We report an extremely rare case of the development of hepatocellular carcinoma (HCC) in cardiac congestive liver fibrosis. A 62-year-old female presented to our hospital with a complaint of right upper quadrant pain. The patient had undergone cardiac surgery for pulmonary valve insufficiency, pulmonary stenosis and atrial septal defect when she was fifteen years of age. During the subsequent 47 years, she had occasionally suffered from various symptoms associated with right-sided heart failure due to pulmonary stenosis. Computed tomography revealed a liver tumor measuring 63 mm in diameter in segment 5 and other liver tumors in segments 5 (18 mm), 8 (17 mm) and 4 (12 mm), which were diagnosed as HCCs. There was no evidence of stenosis in any hepatic veins or inferior vena cava, and no infectious hepatitis or alcoholic liver damage. Anterior sectionectomy and partial resection of segment 4 was performed, and histological examination showed that these tumors were HCC accompanied by congestive liver fibrosis. Nine months later, multiple recurrent HCCs were detected in segment 6, and transcatheter arterial chemoembolization was employed thereafter. The patient died 40 months after surgery due to advanced recurrence.
authors: Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya, Hyogo, 663-8501, Japan, ohashi@hyo-med.ac.jp.
authors: Koichiro
authors: K
authors: Ohashi
authors: Yuji
authors: Y
authors: Iimuro
authors: Kazuhiro
authors: K
authors: Suzumura
authors: Seikan
authors: S
authors: Hai
authors: Shogo
authors: S
authors: Tanaka
authors: Tadamichi
authors: T
authors: Hirano
authors: Hideaki
authors: H
authors: Sueoka
authors: Seiichi
authors: S
authors: Hirota
authors: Jiro
authors: J
authors: Fujimoto
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000473:pathology / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008113:Liver Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local