Hepatocellular carcinoma originated in the caudate lobe. Surgical strategy for resection. A propos of a case

Abstract

Abstract Background Hepatocellular carcinoma originating from the caudate lobe has a worse prognosis than other hepatocellular carcinomas in another segment of the liver. An isolated caudate lobe resection of the liver represents a significant technical challenge. Caudate lobe resection can be performed along with a lobectomy, or as an isolated liver resection. There are very few reports about isolated caudate lobe liver resection. The case is reported here of a successful isolated resection of hepatocellular carcinoma in the caudate lobe with excellent long-term survival. Clinical case A 74 year-old female with 8 cm mass lesion in the caudate lobe with no clinical or biochemical evidence of liver cirrhosis (serum alpha-foetoprotein 3.7 U/l, and negative hepatitis serology), was evaluated for surgery. A complete resection of the lesion in 270 minutes, with Pringle manoeuvre for 13 minutes, was satisfactorily performed. The patient was discharged ten days after surgery without complications, and is currently asymptomatic, with no deterioration of liver function and 48 months tumour-free survival after the procedure. Conclusion Isolated caudate lobe resection is an uncommon, but technically possible procedure. In order to achieve a successful resection, detailed knowledge of complete liver anatomy is essential. Tumour free margins must be obtained to provide long survival for these patients that have a malignancy in this anatomic location.