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Successful surgical treatment for implanted intraperitoneal metastases of ruptured small hepatocellular carcinoma: Report of a case

Surgery Today volume 29, pages 453–457 (1999)Cite this article

Abstract

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 survied long-term after resection of implanted metastasis.

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Affiliations

  1. Department of Surgery, Matsusaka City Hospital, 1550 Tonomachi, 515, Matsusaka, Mie, Japan

    Atsushi Kosaka, Hiroki Hayakawa, Masayuki Kusagawa, Hiroaki Takahashi, Kazunori Okamura & Ryuji Mizumoto

  2. Department of Pathology, Matsusaka City Hospital, 1550 Tonomachi, 515, Matsusaka, Mie, Japan

    Koji Katsuta

Authors
  1. Atsushi Kosaka
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  2. Hiroki Hayakawa
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  3. Masayuki Kusagawa
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  4. Hiroaki Takahashi
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  5. Kazunori Okamura
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  6. Ryuji Mizumoto
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  7. Koji Katsuta
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Kosaka, A., Hayakawa, H., Kusagawa, M. et al. Successful surgical treatment for implanted intraperitoneal metastases of ruptured small hepatocellular carcinoma: Report of a case. Surg Today 29, 453–457 (1999). https://doi.org/10.1007/BF02483040

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  • DOI: https://doi.org/10.1007/BF02483040

Key Words

  • ruptured hepatocellular carcinoma
  • implanted intraperitoneal metastases
  • small hepatocellular carcinoma