Korean J Intern Med.  2009 Mar;24(1):63-67. 10.3904/kjim.2009.24.1.63.

Long-Term Survival in a Patient With Ruptured Hepatocellular Carcinoma

• Kim JS
• Yoon SK
• Kim JA
• Kim CW
• Bae SH
• Choi JY
• Jung CK

• KMID: 1785644
• DOI: http://doi.org/10.3904/kjim.2009.24.1.63

Abstract

A 57-yr-old woman previously diagnosed with chronic hepatitis B was admitted via the emergency room because she suddenly developed epigastric pain with abdominal distension. On computed tomography (CT), a round enhancing mass was found on the left hepatic lobe with ascites in the peritoneal space. Bloody ascites were found upon tapping the ascites, and this led to the diagnosis of ruptured hepatocellular carcinoma (HCC). The patient was immediately treated with transcatheter arterial chemoembolization (TACE) including 50 mg of adriamycin and 10 mL of lipiodol, and then we performed left lateral segmentectomy 20 days later. To prevent recurrence of HCC by any micrometastasis, the patient subsequently received 8 cycles of adjuvant systemic chemotherapy (a regimen of epirubicin (50 mg/m2), cisplatin (60 mg/m2) and 5-fluorouracil (200 mg/m2)) at monthly intervals. After this, the patient has been regularly followed up and she shows no signs of tumor recurrence 7 years later. This case suggests that surgical resection and subsequent adjuvant systemic chemotherapy with using an ECF regimen may provide long-term survival for patients ruptured HCC.

Keyword

Hepatocellular carcinoma; Spontaneous rupture; Hepatic resection; Chemotherapy; Prognosis

MeSH Terms

Biopsy
Carcinoma, Hepatocellular/*diagnosis/therapy
Chemotherapy, Adjuvant
Diagnosis, Differential
Female
Follow-Up Studies
Hepatectomy/methods
Humans
Liver Neoplasms/*diagnosis/therapy
Middle Aged
Rupture, Spontaneous
Time Factors
Tomography, X-Ray Computed