11/995. rupture of hepatocellular carcinoma after transcatheter arterial embolization: an unusual case.rupture of hepatocellular carcinoma (HCC) as a complication of transcatheter arterial embolization (TAE) is very rare. An unusual rupture of HCC after TAE was treated with successful surgical resection. A 65 year-old woman with liver cirrhosis developed multiple HCC in both lobes of the liver. TAE was attempted for the HCCs, but the original left hepatic artery, obliterated due to the previous repeated TAEs, was replaced by the left gastric artery. Right hepatic arteries were embolized while preserving the replaced left hepatic artery. Nine days after TAE, the patient presented a rupture of HCC in the left lateral segment of the liver, in which no deposit of Lipiodol was recognized. Since additional TAE to achieve hemostasis failed, left lateral segmentectomy was carried out with concern for the poor hepatic functional reserve. The patient was discharged 3 weeks after surgery without any complication. This is the first case of ruptured HCC in the non-embolized part of the liver after TAE, which was resected successfully.- - - - - - - - - - ranking = 1keywords = lobe (Clic here for more details about this article) |
12/995. Repeat hepatic resection for recurrent metastatic melanoma.We present an unusual case of a recurrent metastatic hepatic melanoma that had undergone a repeat hepatic resection. A 62 year-old female patient was diagnosed with a plantar melanoma and was managed with resection and regional lymphadenectomy. Eight months later, a solitary liver metastasis was diagnosed and a right hepatectomy performed. Sixteen months later, a recurrent solitary metastasis was diagnosed in the caudate lobe and resection was performed. She has since been asymptomatic with no evidence of recurrence of the disease at a 2-year follow up. We recommend surgical removal of hepatic metastatic melanoma in selected cases where the disease is confined to the liver and surgery can be performed without unacceptable risk.- - - - - - - - - - ranking = 1keywords = lobe (Clic here for more details about this article) |
13/995. Calcification in mucinous cholangiocellular carcinoma.Calcification is rarely seen in cholangiocellular carcinoma. We herein report the case of a 53 year-old man with calcification in a cholangiocellular carcinoma. Because imaging studies had revealed coarse calcified foci, hepatolithiasis was suspected pre-operatively. The patient underwent a laparotomy in which intra-operative cholangioscopy revealed no gallstones but did reveal an unsuspected tumor with abundant mucin. A left hepatic lobectomy with resection of the extrahepatic bile duct was performed. The tumor histology was mucinous adenocarcinoma with calcification. In the English language literature, we found 9 cases of cholangiocellular carcinoma with macroscopic calcification. Six of these cases were mucinous adenocarcinomas. Roentgenologic examination revealed coarse calcification in 7 cases and fine calcification in 2 cases. Clinicians should note that cholangiocellular carcinoma, especially the mucinous variant, may be accompanied by coarse calcification.- - - - - - - - - - ranking = 1keywords = lobe (Clic here for more details about this article) |
14/995. Rapid evolution of chronic viral hepatitis into hepatocellular carcinoma after beta-interferon treatment.A 62-year-old man, affected by Chronic Active hepatitis (discovered in 1993) and treated with interferon, referred to our department with increased abdominal volume, persistent abdominal pain, continuous-remittent fever and jaundice. CT scan of the liver revealed a hypodense, not capsulated, infiltrative, solid formation in the right lobe. US guided biopsy showed multinucleated giant cells, with eosinophilic cytoplasm and pleomorphism of the nuclei, arranged in several thick trabecula lined by endothelial cells or formed bile containing acini. In our case, the rapid evolution of chronic viral hepatitis towards HCC calls for a careful evaluation of the role of IFN therapy, since this drug is widely used in chronic liver diseases.- - - - - - - - - - ranking = 1keywords = lobe (Clic here for more details about this article) |
15/995. A long-term survival patient with advanced gallbladder cancer massively metastasizing to the liver.A case of gallbladder carcinoma was reported. A 42-year-old woman was admitted with epigastralgia. Abdominal ultrasonography, computed tomography, and other diagnostic modalities suggested gallbladder carcinoma with multiple liver metastases. These findings indicated no surgical procedure because of the advanced nature of her disease. After the hepatic arterial chemoinfusion therapy, her multiple liver metastatic lesions showed a decrease in size and number. Therefore, extended left lobectomy of the liver with gallbladder and bile duct resection were performed. Five years after initial operation, a solitary liver metastatic lesion (S5) was diagnosed by ultrasonography. Partial resection of the liver was performed for the liver metastasis, and her postoperative recovery was uneventful and had a good follow-up course. One year after the second operation bone metastases occurred, therefore, peroral administration of UFT (tegafur uracil) and radiation therapy for the metastatic lesions of sternum and lumbar vertebra (L1) were performed.- - - - - - - - - - ranking = 1keywords = lobe (Clic here for more details about this article) |
16/995. 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 = lobe (Clic here for more details about this article) |
17/995. Malignant pheochromocytoma with multiple hepatic metastases treated by chemotherapy and transcatheter arterial embolization.A 62-year-old Japanese male developed multiple hepatic metastases two years after resection of pheochromocytoma of the right adrenal gland. Transcatheter arterial embolization (TAE) was performed for the purpose of the treatment of hepatic metastases resistant to 27 cycles of combined chemotherapy consisting of cyclophosphamide, vincristine, and dacarbazine. After TAE, the hepatic metastatic lesions decreased in size and hypertension passed its crisis. The present case suggests the utility of TAE for multiple hepatic metastases under careful blood pressure monitoring.- - - - - - - - - - ranking = 0.12575512445045keywords = gland (Clic here for more details about this article) |
18/995. Primary hepatic lymphoma associated with primary biliary cirrhosis.We report a case of primary hepatic lymphoma in a 55-yr-old female patient with primary biliary cirrhosis and sjogren's syndrome. On July 1994, a tumor measuring 11 mm in diameter was detected in the right lobe of the liver by abdominal ultrasonography. A needle biopsy specimen showed the lesion to contain small- and medium-sized lymphoid cells without obvious atypia, and a provisional diagnosis of pseudolymphoma was made. About 2 yr later, the tumor increased to 15 mm in diameter, necessitating a second needle biopsy. Histological and genetic examinations confirmed non-Hodgkin's lymphoma of diffuse, mixed small and large cell, B-cell type. However, the size of the tumor remained almost stable (16 mm in diameter) over a period of 7 months after diagnosis, without any treatment for lymphoma, indicating a low grade malignancy. We document hepatic lymphoma as an additional complication of primary biliary cirrhosis.- - - - - - - - - - ranking = 1keywords = lobe (Clic here for more details about this article) |
19/995. Imaging findings in primary carcinoid tumour of the liver with gastrin production.We present a 57-year-old man with zollinger-ellison syndrome who had undergone total gastrectomy 12 years previously. At that time, a cystic mass in the left lobe of the liver was palpated but was not removed. The patient currently had high serum gastrin levels. Abdominal ultrasound, CT and MR images showed a well defined liver mass with solid and cystic components. The lesion was resected and a primary hepatic carcinoid tumour was diagnosed. Post-operatively, serum gastrin levels were normal. A primary liver carcinoid may appear as multicystic liver mass with solid components. Careful exclusion of a primary tumour elsewhere is required to establish the diagnosis of this rare entity.- - - - - - - - - - ranking = 1keywords = lobe (Clic here for more details about this article) |
20/995. Progressive development of diffuse liver hemangiomatosis.Diffuse liver hemangiomatosis is extremely rare. The etiology and natural history of the disease are unknown. It is also unclear whether tumor growth is induced or modulated by drug therapy. Tumor recurrence after ablative therapy has not been described in patients with diffuse liver hemangiomatosis. Diffuse hemangiomatosis of the left hepatic lobe was suspected in a 35-year-old woman by ultrasonography, CT and hepatic arteriography, and confirmed by laparotomy and biopsies. The patient denied any drug or estrogen use. The tumor was removed by left hepatectomy. Two and six years later, the patient was again hospitalized with progressive tumor growth into the right hepatic lobe. Although diffuse liver hemangiomatosis is a rare disease, its diagnosis should be considered in patients with progressive tumor growth in one or both hepatic lobes. The absence of drug intake or estrogen use does not exclude the diagnosis.- - - - - - - - - - ranking = 3keywords = lobe (Clic here for more details about this article) |
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