Abstract
We report herein the case of a 69-year-old woman in whom hepatocellular carcinoma (HCC) arising in the precirrhotic phase of primary biliary cirrhosis (PBC) was successfully managed by a right hepatic lobectomy. The patient, who had never received a blood transfusion, had a 4-year history of asymptomatic PBC of Scheuer's histological classification stage II. Abdominal computed tomography (CT) revealed a mass measuring 4.0 cm in the right hepatic lobe, and a right hepatic lobectomy was performed in consideration of her good liver function and the deep location of the tumor in the right lobe. The patient has remained well without any evidence of recurrent disease for 4 years since her operation. A review of the literature revealed only two cases of successful partial hepatectomy, but none of major hepatectomy. Most of the reported cases had been treated with transcatheter arterial embolization (TAE) and were associated with poor survival. Our experience of this patient indicates the potential value of hepatectomy as an alternative to TAE in selected patients with resectable disease and good hepatic function.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Krasner N, Johnson PJ, Portmann B, Watkinson G, Macsween RNM, Williams R (1979) Hepatocellular carcinoma in primary biliary cirrhosis: Report of four cases. Gut 20:255–258
Mallet L, Petite JP, Amat D, Bloch F, Juillet Y, Camilleri JP, Housset E (1981) Carcinome hépatocellulaire au cours de la cirrhose billiaire primitive. Gastroenterol Clin Biol 5:379–384
Terris G, Lande P, Vaury P (1982) Carcinome hépatocellulaire et cirrhose biliaire primitive: une nouvelle observation. Gastroenterol Clin Biol 6:593–594
Melia WM, Johnson PJ, Neuberger J, Zaman S, Portmann BC, Williams R (1984) Hepatocellular carcinoma in primary biliary cirrhosis: Detection by alpha-fetoprotein estimation. Gastroenterology 87:660–663
Wolke AM, Schaffner F, Kapelman B, Sacks HS (1984) Malignancy in primary biliary cirrhosis. Am J Med 76:1075–1078
Gluskin LE, Guariglia P, Payne JA, Banner BF, Economou P (1985) Hepatocellular carcinoma in a patient with precirrhotic primary biliary cirrhosis. J Clin Gastroenterol 7:441–444
Takagi F, Takahashi A, Yokoyama T (1985) Hepatocellular carcinoma in primary biliary cirrhosis: Report of an autopsy case (in Japanese with English abstract). Rinsho to Byori (Pathol Clin Med) 3:664–668
Sakaeda H, Saibara T, Fujikawa M, Maeda T, Onishi S, Ito K, Hiroi M, Moriki T, Enzan H, Hara H, Sonobe H (1986) A case of a 80-year-old man with primary biliary cirrhosis complicated with primary hepatocellular carcinoma (in Japanese with English abstract). Kanzo (Acta Hepatol Jpn) 27:497–503
Ichida T, Hatano T, Sasagawa T, Nakazawa T, Sasaki M, Kamimura T, Asakura H (1990) A case report of hepatocellular carcinoma in primary biliary cirrhosis (in Japanese). Kan Tan Sui (Liver Bil Tract Pancreas) 21:969–975
Nakanuma Y, Terada T, Doishita K, Miwa A (1990) Hepatocellular carcinoma in primary biliary cirrhosis: an autopsy study. Hepatology 11:1010–1016
Yokote M, Nishikawa K, Wako Y, Shoji S, Yokote M, Takikawa H, Miyake K, Yamanaka M, Kato A (1991) A case of primary biliary cirrhosis complicated with hepatocellular carcinoma (in Japanese with English abstract). Teikyo Igaku Zasshi (Teikyo Med J) 14:409–415
Hata K, Nagayama S, Hatakeyama S, Ohkoshi S, Hatano T, Hayakawa A, Nomoto M, Ichida T, Aoyagi Y, Kamimura T (1992) A case of hepatocellular carcinoma in primary biliary cirrhosis positive for anti-HCV (in Japanese with English abstract). Kanzo (Acta Hepatol Jpn) 33:167–173
Takezaki E, Murakami S, Nishibayashi H, Kagawa K, Ohmori H, Katayama S, Hiroi T (1992) Hepatocellular carcinoma in primary biliary cirrhosis: Report of an autopsy case (in Japanese). Rinsho Syoukaki Naika (Clin Gastroenterol) 7:1811–1814
Yano Y, Tsuji H, Kawatoko T, Fujishima M, Matsumata T, Yasunaga C, Sueishi K (1993) A case of hepatocellular carcinoma associated with HCV antibody-positive primary biliary cirrhosis, treated with established surgical resection (in Japanese with English abstract). Kanzo (Acta Hepatol Jpn) 34:723–727
Inoue F, Saka Y, Sugiyama T, Furukawa H, Saiga T (1994) Hepatocellular carcinoma in a patient with primary biliary cirrhosis (in Japanese). Nippon Syoukakibyo Gakkai Zasshi (Jpn J Gastroenterol) 91:1047–1051
Miura Y, Kaneda Y, Tohyama J, Katayama S, Takikawa Y, Nakatate I, Saitoh H, Yamazaki K, Hanme T, Yoshida T, Kashiwabara N, Suzuki K, Satoh S, Masuda T (1994) Icteric-type hepatoma in a patient with primary biliary cirrhosis (in Japanese). Kan Tan Sui (Liver Bil Tract Pancreas) 28:129–134
Takenawa H, Sakuma I, Yamaoka K, Yamane M, Shaura K, Sakai H, Ikeda T, Marumo F, Sato C (1994) Hepatocellular carcinoma complicating primary biliary cirrhosis — a case report and a review of the literature (in Japanese). Nippon Syoukakibyo Gakkai Zasshi (Jpn J Gastroenterol) 91:2127–2132
Liver Cancer Study Group of Japan (1992) The General Rules for the Clinical and Pathological Study of Primary Liver Cancer, 3rd edn. Kanehara Publications, Tokyo, Japan
Scheuer P (1967) Primary biliary cirrhosis. Proc R Soc Med 60:1257–1260
Sherlock S (1959) Primary biliary cirrhosis (chronic intrahepatic obstructive jaundice). Gastroenterology 37:574–586
Roll J, Boyer JL, Barry D, Klatskin G (1983) The prognostic importance of clinical and histologic features in asymptomatic and symptomatic primary biliary cirrhosis. N Engl J Med 308:1–7
Farmer DG, Rosove MH, Shaked A, Busuttil RW (1994) Current treatment modalities for hepatocellular carcinoma. Ann Surg 219:236–247
Iwatsuki S, Starzl TE, Sheahan DG, Yokoyama I, Demetris AJ, Todo S, Tzakis AG, Thiel DH, Carr B, Selby R, Madariaga J (1991) Hepatic resection versus transplantation for hepatocellular carcinoma. Ann Surg 214:221–228
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Wakai, T., Shirai, Y., Tsukada, K. et al. Hepatocellular carcinoma associated with precirrhotic primary biliary cirrhosis successfully treated by a right hepatic lobectomy: Report of a case. Surg Today 26, 723–726 (1996). https://doi.org/10.1007/BF00312093
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00312093