Laparoscopically Resected Solitary Metastasis of Hepatocellular Carcinoma to the Round Ligament

Abstract

Hepatocellular carcinoma (HCC) is known to metastasize to the lung, lymph node, and musculoskeletal regions; however, to our knowledge, metastasis to the round ligament of the liver has never been reported. In addition, because the conventional approach for surgical resection of intra-abdominal metastasis is open surgery, the laparoscopic approach has been rarely performed. This report presents the case of a 72-year-old Asian man who developed a tumor in the round ligament, a rare site for distant metastases, 2 years after complete resection of an HCC. As the tumor was solitary and noninvasive, laparoscopic resection was planned and safely performed. He has now been free of recurrence for more than 3 years. Good perioperative outcomes and a long-term disease-free survival were thus achieved with minimally invasive surgery. In addition to being the first report of this rare recurrence site, this is also the first reported case of resection of an extrahepatic metastasis by laparoscopic surgery alone. This report may encourage surgeons to select a laparoscopic approach when managing intra-abdominal metastases from an HCC.