Abstract
IntroductionRepeat hepatic resection has previously been reported as the most effective treatment for recurrence of intrahepatic carcinoma. To the best of our knowledge, en bloc resection of recurrent hepatocellular carcinoma directly invading the abdominal wall has not been previously reported.Case presentationIn September 2012, a 64-year-old Chinese male patient was referred to our hospital because of primary hepatocellular carcinoma located in Couinaud’s segments III and V. Our patient first had a hepatectomy of the liver. Ten months later, he presented with an abdominal wall mass and upper abdominal pain. Computed tomography and magnetic resonance imaging scans demonstrated a 10cm tumor in his left liver with extrahepatic metastases in his abdominal wall. It was determined that he had recurrent hepatocellular carcinoma associated with direct invasion into his abdominal wall. He had an en bloc left hepatectomy with resection of the tumor in his abdominal wall. A pathological examination of the resected specimen confirmed the diagnosis of hepatocellular carcinoma involving the abdominal wall. Disease-free margins of resection were achieved. Our patient’s postoperative course was uneventful. Eight months after the last surgery, our patient died owing to recurrence and distal metastasis.ConclusionDirect invasion of hepatocellular carcinoma into the abdominal wall is rarely encountered. Complete surgical resection should be considered in patients with an appropriate hepatic functional reserve, with consideration of the technical difficulty relating to tumor involvement with surrounding tissues.
Highlights
Repeat hepatic resection has previously been reported as the most effective treatment for recurrence of intrahepatic carcinoma
Because of the extrahepatic tumor invasion and the recurrence of the Hepatocellular carcinoma (HCC) directly invading his abdominal wall, a hepatectomy and surgical resectioning of his abdominal wall were considered as the procedure of choice
Many authors have suggested that repeat hepatic resection might be the most effective treatment for intrahepatic recurrence, and the fiveyear survival rate following re-resection ranges from 31% to 69% [17,18]
Summary
We selected to treat our patient’s extrahepatic tumor invasion of the abdominal wall and HCC recurrence with combined resection. We have reported a rare case of a patient who successfully underwent repeat resections for hepatic recurrences directly invading his abdominal wall after hepatectomy for HCC. To prevent postoperative recurrence of HCC, patients require comprehensive treatment. Consent Written informed consent was obtained from the patient’s of kin for publication of this case report and any accompanying images. Competing interests The authors declare that they have no competing interests. Authors’ contributions AL conceived and designed the surgery, and drafted the manuscript. BW and LC participated in the surgery and performed the acquisition of data and statistical analysis. MW carried out a critical revision of the manuscript. All authors read and approved the final manuscript
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