1/42. Successful surgical treatment for implanted intraperitoneal metastases of ruptured small hepatocellular carcinoma: report of a case.We report herein the case of a 53-year-old man with disseminated intraperitoneal metastases caused by the rupture of small hepatocellular carcinoma (HCC). He was admitted to our hospital in shock after suffering a trauma injury to the upper abdomen. ultrasonography revealed a massive hemoperitoneum. At surgery, 4000 ml of blood was drained from the abdominal cavity and a ruptured tumor, 2 cm in diameter, was found in the right lobe of the liver. The tumor was resected with an adequate surgical margin and subsequent microscopic examination confirmed a diagnosis of moderately differentiated HCC without associated liver cirrhosis. The patient was readmitted 14 months later following the development of right lower quadrant pain. ultrasonography and computed tomography revealed extrahepatic abdominal tumors, and abdominal angiography demonstrated four intraperitoneal tumors. At surgery, four implanted metastases adhered to the greater omentum were found and resected. No other tumors were detected. Microscopically, all four tumors were confirmed as moderately differentiated hepatocellular carcinoma. Ruptured HCC may lead to implanted intraperitoneal metastasis, but rupture of small HCC is very rare. While hepatic resection is the treatment of choice for ruptured HCC, according to our review of the literature, only a few patients have survived long-term after resection of implanted metastasis.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
2/42. Generalized intraperitoneal seeding of hepatocellular carcinoma after microwave coagulation therapy: a case report.We first describe a case of generalized intraperitoneal seeding of hepatocellular carcinoma (HCC) after microwave coagulation therapy (MCT). A 61 year-old man underwent operative MCT for an exophytic HCC, 60 mm in diameter, in segment IV of his cirrhotic liver. Despite successful tumor ablation, the serum alpha-fetoprotein levels continuously rose after MCT. Five months later, radiographic examinations delineated several perihepatic masses with hypervascularity, and the patient presented with constipation. At the second laparotomy, there were numerous small peritoneal metastases involving the entire peritoneal cavity and slightly bloody ascites. An omental mass, 50 mm in diameter, involved the transverse colon. Most of these intraabdominal masses were removed together with the involved colon. Histologically, the initial tumor was a moderately differentiated HCC, and the peritoneal masses were poorly differentiated HCCs. The patient died of rapid tumor progression and bleeding 2 months later. In conclusion, we should be aware of the possible occurrence of peritoneal seeding after MCT for HCC. Every effort should be made to prevent this serious complication, particularly in cases of superficial, large, and less differentiated HCCs.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
3/42. Gingival lesions and nasal obstruction in an immunosuppressed patient post-liver transplantation.Although rare, metastatic hepatocellular carcinoma (HCC) presenting only to the mandible, gingiva, and nasal cavity in patients subsequently found to have primary HCC has been reported. In the age of transplantation, certain HCC patients may receive treatment with an orthotopic liver transplant. Due to the proclivity of HCC for early micrometastases, immunosuppressive therapy can induce significant metastatic lesions. Nasal mass obstruction, gingival lesions, or facial growths in this population must be considered metastatic until proven otherwise.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
4/42. Peritoneal seeding of hepatocellular carcinoma after ethanol injection therapy.The tumor seeding due to percutaneous ethanol injection therapy has been considered to be a very rare complication. Four cases of peritoneal seeding of hepatocellular carcinoma following percutaneous ethanol injection therapy are presented here. All patients had been initially treated for hepatocellular carcinomas with percutaneous ethanol injection therapy. Between 5 and 20 months after the percutaneous ethanol injection therapy, peritoneal seeding tumors were detected and resected surgically. Three patients recurred in the liver and one patient recurred in the abdominal cavity. Two died of cancer and 2 are still alive. The incidence of seeding following percutaneous ethanol injection therapy should not be so rare as considered referring to that due to fine needle biopsy, therefore careful attentions should be paid during the follow-up of those patients after percutaneous ethanol injection therapy.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
5/42. Successful surgical treatment for implanted intraperitoneal metastases of hepatocellular carcinoma.We report here two patients with hepatocellular carcinoma who experienced implanted metastases in the abdominal cavity after hepatectomy or microwave coagulo-necrotic therapy. Hepatic resection and microwave coagulo-necrotic therapy were successful for these tumors, and the postoperative status was satisfactory in both patients. Implanted metastases were discovered in the abdominal cavity of each of these two patients 6 months after surgery. It is necessary to look not only for the presence of liver metastasis but also for the recurrence of the tumor in the abdominal cavity during the follow-up period. Generally, surgical resection for intraabdominal implanted tumors arising from any other abdominal organs is not indicated for improving the patient's quality of life. However, resection of metastatic tumors that occur in the abdominal cavity, arising from hepatocellular carcinoma may be of value in improving patient survival.- - - - - - - - - - ranking = 4keywords = cavity (Clic here for more details about this article) |
6/42. Successful treatment of dissemination of hepatocellular carcinoma to the pleura and diaphragm after percutaneous liver biopsy.BACKGROUND/AIM: Treatment for dissemination of hepatocellular carcinoma to the pleura and diaphragm following percutaneous needle biopsy has not been established. methods: The case of a 57-year-old man who underwent percutaneous needle biopsy for liver tumor is presented. RESULTS: Ten months after resection of the tumor (moderately differentiated hepatocellular carcinoma), masses in the right pleural cavity and on the diaphragm were detected by computed tomography. Resections of the masses with surrounding tissue and the diaphragm and wedge resection of the right lung were performed. A wide range of the pleura and the diaphragm was coagulated with an argon beam coagulator. The patient is in good health without recurrence 4 years after the operation. CONCLUSION: Aggressive surgical treatment should be considered for patients with dissemination of hepatocellular carcinoma by needle biopsy when the lesions are limited.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
7/42. An approach to intrapericardial inferior vena cava through the abdominal cavity, without median sternotomy, for total hepatic vascular exclusion.In surgical resection for hepatocellular carcinoma with tumor thrombus extending into the inferior vena cava and other malignancies involving the retrohepatic inferior vena cava, the usefulness of total hepatic vascular exclusion has been reported by several authors. Total hepatic vascular exclusion usually consists of clamping at three points; at the infrahepatic inferior vena cava, at the suprahepatic inferior vena cava, and in Pringles' maneuver. Tumor thrombus extending into the inferior vena cava at the intrapericardial level below the right atrium can be resected without the use of cardio-pulmonary bypass. The inferior vena cava at the intrapericardial level has been reported to be usually approached by median sternotomy such as Chevron incision. We herein demonstrate an approach to the intrapericardial inferior vena cava through the abdominal cavity without median sternotomy.- - - - - - - - - - ranking = 5keywords = cavity (Clic here for more details about this article) |
8/42. Hepatocellular cancer metastatic to the zygoma: primary resection and immediate reconstruction.Hepatocellular carcinoma is common worldwide but relatively rare in the united states, where only 13,000 new cases are diagnosed each year. Metastasis to osseous structures in the head and neck are extremely rare; when they do occur, most appear as oral cavity masses secondary to mandibular and maxillary involvement. We report the case of an isolated zygomatic metastasis in a patient who had been previously treated for hepatocellular carcinoma with orthotopic liver transplantation. The patient underwent a complete excision of the mass followed by immediate reconstruction of the zygomaxillary buttress and the orbital rim and floor. To our knowledge, only one other case similar to ours has been previously reported; in that instance, the metastatic tumor was not resectable.- - - - - - - - - - ranking = 2.7074582508841keywords = oral cavity, cavity (Clic here for more details about this article) |
9/42. Percutaneous radiofrequency ablation therapy after intrathoracic saline solution infusion for liver tumor in the hepatic dome.Two liver tumors undetected by ultrasonography (US) because they were located in the hepatic dome were treated with radiofrequency (RF) ablation therapy after intrathoracic saline solution infusion. After administration of local anesthesia, artificial pneumothorax was produced by needle thoracentesis and a drainage catheter was inserted into the right thoracic cavity. After saline solution (450-500 mL) was injected into the thoracic cavity via the catheter, US-guided RF ablation was performed. No severe complications occurred and complete therapeutic effects were obtained. Percutaneous RF ablation therapy with intrathoracic saline solution injection seems to be a feasible alternative to other ablation therapies.- - - - - - - - - - ranking = 2keywords = cavity (Clic here for more details about this article) |
10/42. Successful surgical control for hepatocellular carcinoma disseminated to the peritoneum: a case report.Treatment for dissemination of hepatocellular carcinoma to the peritoneum has not yet been established. A case of a 62-year-old man who underwent curative resection for hepatocellular carcinoma 1 month after ultrasonically guided needle biopsy is presented. At 23 months after surgery, computed tomography revealed a mass in the abdominal cavity. At laparotomy 3 months later, a peritoneal tumor deposit directly invading the colon was resected in continuity with a portion of large intestine. The tumor was confirmed histopathologically to represent dissemination of hepatocellular carcinoma. No other lesions were detected 20 months after the second operation. Surgical treatment can locally control peritoneally disseminated hepatocellular carcinoma provided that lesions have limited extent.- - - - - - - - - - ranking = 1keywords = cavity (Clic here for more details about this article) |
| | Next -> |