1/119. Multiple hepatic angiolipomas: a case report and review of literature.Follow-up of two hepatic angiolipomas in a patient without evidence of tuberous sclerosis is reported. Initially, the lesions presented as homogenously enhancing masses, which were nearly isodense to normal liver tissue on plain CT scans. focal nodular hyperplasia was assumed. One year later, fat was detected in the growing tumors and percutaneous core biopsy revealed hepatic angiolipomas. natural history of these rare lesions is unknown, and this is to the best of our knowledge the first observation of fatty metamorphosis in such a benign, mesenchymal hepatic neoplasm.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
2/119. Recurrent hepatocellular carcinoma successfully treated with radiofrequency thermal ablation.We report a patient with hepatocellular carcinoma (HCC) who was successfully treated with radiofrequency thermal ablation (RFA). A 71-year-old man was admitted to our hospital in August 1996 with recurrence of HCC. Partial hepatic resection had been performed in January 1993 for HCC that had measured 1.3 cm in segment VIII, and subsequently he had received six sessions of percutaneous ethanol injection (PEI) for treatment of recurrence. Dynamic computed tomography (CT) performed in August 1996 showed two recurrent tumors, one measuring 3.8 cm in segment VIII adjacent to the right hepatic vein, and one measuring 2.0 cm in segment V. Three sessions of percutaneous RFA were performed. After this treatment, most of the tumor in segment VIII and all the tumor in segment V showed low density on dynamic CT, and the right hepatic vein was preserved. However, a remnant of the mass appeared near the right hepatic vein 2 months after the treatment. An additional two sessions of RFA were performed. After the end of treatment, serum alpha-fetoprotein level dropped to the normal range, and no sign of recurrence has been observed until September 1998.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
3/119. Spontaneous regression of hepatocellular carcinoma.A 62-year-old Japanese man with hepatitis b virus-related liver cirrhosis revealed alpha-fetoprotein (AFP) elevation. Dynamic computed tomography, taken at this time, showed a liver tumor in the anterior segment. As the patient refused any further medical treatment, he was observed in an outpatient clinic. The size of the tumor reduced and the serum level of AFP decreased gradually without any treatment. Twelve months after the initial diagnosis, the tumor could not be detected by computed tomography (CT) scan, and the level of AFP had declined to the normal range. Blood supply is essential for tumor growth and an arterioportal shunt near the tumor may change the dynamics of blood flow to the tumor. The shunt found in this patient was thought to be one of the causative factors leading to regression, but it could not be denied that immunological mechanisms may have played an important role in the spontaneous regression of hepatocellular carcinoma.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
4/119. Hepatocellular carcinoma with metastasis to the rib complicated by hemothorax. An autopsy case.A 64-year old man was admitted to our hospital with multiple hepatocellular carcinoma (HCC) lesions in the liver, lung and bone. Three weeks after admission, the patient became complicated with right upper chest pain. A chest radiograph showed a marked increase in right pleural effusion. Thoracentesis demonstrated a hemothorax. Despite treatment with a continuous pleural tap and blood transfusions, the patient's clinical status worsened and he developed severe dyspnea. His right pleural effusion might be considered to be caused by a rupture of the HCC metastasis in the right 2nd rib. The patient died due to respiratory and hepatic failure 26 hours after his occurring the pleural effusion. An autopsy revealed moderately differentiated HCC in the liver, lung and bone. The HCC metastasis of the right 2nd rib was found to have torn the nearby pleura. We described a rare case in which hemothorax was caused by a ruptured rib-based HCC.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
5/119. A long-term survivor undergoing extensive microwave coagulation for unresectable hepatocellular carcinoma.Surgery for advanced hepatocellular carcinomas (HCCs) has not been standardized. We report on a long-term tumor-free survivor who underwent extensive microwave coagulation therapy (MCT) for multiple bilobar HCCs. A 61 year-old woman was diagnosed to have bilobar HCCs, including a large tumor, 9 cm in diameter, and 4 small satellite nodules, associated with chronic hepatitis B. The patient had received repeated chemoembolizations using iodized oil, but the increased alpha-fetoprotein level did not fall to normal. The main tumor was unresectable because the tumor involved the caval vein and hepatic veins. The patient underwent extensive MCT with a total of 134 electrode insertions. The paracaval portion of the main tumor was meticulously coagulated under sonographic guidance to avoid vascular injury. The post-operative course was uneventful. Post-operative computed tomography (CT) showed complete necrosis of all tumors. The patient is alive without tumor recurrence for 4 years after MCT. This case proves that extensive MCT can provide a chance of cure in selected patients with multiple bilobar HCCs and centrally located HCCs near the caval vein.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
6/119. bronchogenic cyst appearing as a hepatic mass.Because bronchogenic cysts may be found in or near any organ derived from the embryonic foregut, they sometimes pose considerable diagnostic difficulties. We describe the plain chest X-ray, computed tomographic, and angiographic findings in a patient with elevated CA 19-9 and upper quadrant abdominal pain due to a cystic tumor appearing as a hepatic mass. Surgery and histology showed a bronchogenic cyst located in the lower lobe of the right lung.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
7/119. Establishment and characterization of a spontaneously immortalized myofibroblast cell line derived from a human liver angiosarcoma.BACKGROUND/AIM: fibrosis and/or cirrhosis are present in the precursor stages of most liver cancers. However, little is known about the reciprocal interactions of fibroblasts, mainly responsible for fibrosis, and the other liver cells. We report here the isolation of a new liver myofibroblast cell line from a human liver angiosarcoma and its characterization. methods: The cells were isolated by the explant technique and characterization was performed, on one hand, using immunohistochemical and ultrastructural analysis and, in the other hand, by determining their karyotype, ras and p53 status and their tumorigenic properties. RESULTS: To date, the cells have undergone approximately 170 population doublings and are still proliferating. Immunohistochemically, they were negative for desmin, smooth muscle myosin, cytokeratin 19 and von willebrand factor, positive for vimentin and alpha-smooth muscle actin, with an important deposition of fibronectin around the cells. Ultrastructure showed particularly cytoplasmic microfilament bundles. Their chromosome number ranged from 38 to 168 with a bimodal population, near diploid and hypotetraploid. No mutations were found in codons 12, 13 or 61 of Ha-, Ki- and N-ras genes but a homozygous missense mutation in codon 179 (CAT-->CTT) was detected in the p53 gene. They were unable to form foci in soft agar or tumors in nude mice. CONCLUSIONS: Taken together, these results show that these cells, called BM 2.2.1, exhibited typical myofibroblast-like features. Although they contained a karyotype suggestive of tumoral cells and a homozygous mutated p53 gene, they were not tumorigenic. The nature of these cells and the abnormalities of the p53 gene and the karyotype, suggest that: i) they were a component of the tumor stroma, and ii) they could have been involved in angiosarcoma development. Thus, this cell line may be valuable for the study of cellular interactions in liver carcinogenesis.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
8/119. Hepatic lymphangioma--a case report.A patient presented with a huge, pedunculated abdominal cystic lymphangioma arising from the quadrate lobe of the liver near the round ligament. Microscopically, dilated hepatic ducts with scant liver tissue could be recognized in the main cyst. A review of the literature reveals no previous report of a lymphangioma arising in this manner or from this area.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
9/119. Identification of hepatic venous territories in liver resection by using color Doppler ultrasonography: report of two cases.OBJECTIVE: Resection of the hepatic vein because of the proximity of tumors may result in increased congestion in the noncancerous parenchyma, which in turn may lead to functional hepatic volume loss and postoperative hepatic failure, especially in a case of low hepatic reserve. However, to our knowledge, no technique for estimating the extent of dependent hepatic venous territories before hepatic resection has been established. We examined the possibility of using color Doppler ultrasonography for this purpose. methods: A color Doppler system and a linear array transducer equipped with multiple Doppler frequencies ranging from 7 to 13 MHz were used intraoperatively. Two patients with hepatocellular carcinomas were examined. By tracking entire branches of the targeted vessel, from the trunk to the terminal branches extending to the liver surface, it was possible for the boundaries of the dependent areas to be projected and marked on the liver surface with either ink or electrocautery. RESULTS: In both cases, this method was effective for either minimizing the congestive area or preserving the hepatic mass that was being drained via aberrant routes. CONCLUSIONS: Identification of hepatic venous territories by means of color Doppler ultrasonography may provide new information about intrahepatic blood circulation and may increase the safety and curability of hepatic resection.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
10/119. Fibrolamellar hepatocellular carcinoma with skeletal metastases.Skeletal metastases is relatively rare in hepatocellular carcinoma and accounts for 4-16% of extrahepatic metastases. The authors report a 13-year-old girl with fibrolamellar hepatocellular carcinoma, who rejected further systemic chemotherapy following hepatic lobectomy and experienced sternal and vertebral painful metastases nearly 5 years after the operation. The sternal metastatic lesion was removed surgically, whereas external irradiation was delivered to the lumbar vertebral lesion. The patient received no systemic treatment following metastases and died with widespread disease. Despite metastatic disease, the patient survived 6.5 years following the initial diagnosis.- - - - - - - - - - ranking = 1keywords = near (Clic here for more details about this article) |
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