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Surgery Today

, Volume 29, Issue 7, pp 646–650 | Cite as

Right hepatic lobectomy for hepatocellular carcinoma which developed in primary biliary cirrhosis: Report of a case

  • Taisuke Morimoto
  • Goro Honda
  • Yasuhiro Kawai
  • Tetsuro Hirose
  • Toshihiro Nishio
  • Nobuhiko Shinkura
  • Yuji Iimuro
  • Naritaka Yamamoto
  • Yuzo Yamamoto
  • Iwao Ikai
  • Yasuyuki Shimahara
  • Yoshio Yamaoka
Case Reports

Abstract

The case of a 74-year-old female patient who underwent a right hepatic lobectomy for hepatocellular carcinoma (HCC) which developed in primary biliary cirrhosis (PBC) is reported herein. During a follow-up examination for Parkinson’s disease, an elevation of hepatobiliary tractrelated enzymes and α-fetoprotein was uncovered. Diagnostic imagings showed a hypervascular, solitary, and encapsulated tumor measuring about 7 cm in diameter located mainly in the posterior segment. Positive antimitochondrial and antinuclear antibodies and a preoperative liver biopsy strongly suggested well differentiated HCC developed in PBC (Scheuer’s classification stage II). Since the natural prognosis of PBC estimated by the Mayo risk score was fairly good and the liver function indicated sufficient tolerance for major hepatic resection, and preoperative computed tomography (CT) volumetry showed the atrophy of the right hepatic lobe, a right hepatic lobectomy was performed. A pathological examination revealed well encapsulated, moderately differentiated HCC with, in part, well-differentiated HCC in the tumor and stage II PBC in the noncancerous region. CT volumetry performed at postoperative day 14 showed a 146% enlargement of the remnant liver. An early detection of HCC and PBC by strict screening would prevent a limitation of surgical therapy due to a deteriorated liver function.

Key Words

hepatocellular carcinoma primary biliary cirrhosis right hepatic lobectomy postoperative volumetry 

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Copyright information

© Springer-Verlag 1999

Authors and Affiliations

  • Taisuke Morimoto
    • 1
  • Goro Honda
    • 1
  • Yasuhiro Kawai
    • 1
  • Tetsuro Hirose
    • 1
  • Toshihiro Nishio
    • 1
  • Nobuhiko Shinkura
    • 1
  • Yuji Iimuro
    • 1
  • Naritaka Yamamoto
    • 1
  • Yuzo Yamamoto
    • 1
  • Iwao Ikai
    • 1
  • Yasuyuki Shimahara
    • 1
  • Yoshio Yamaoka
    • 1
  1. 1.Department of Gastroenterological SurgeryKyoto University Graduate School of MedicineKyotoJapan

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