Extrahepatically growing hepatocellular carcinoma with direct invasion into the spleen

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 73; no. 8; pp. 2027 - 2034
• Main Authors: YAMAGUCHI, Masaki, BABA, Katsuyoshi, TAKAO, Takashi, SHINGAMI, Kouji, UJI, Yoshitaka, IRIE, Kouji
• Format: Journal Article
• Language: Japanese
• Published: Japan Surgical Association 2012
• Subjects: extrahepatic growth; hepatocellular carcinoma; spleen
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.73.2027

An 82-year-old woman with HBV-related hepatitis was diagnosed with extrahepatically growing hepatocellular carcinoma in the lateral segment of the liver. At the time of diagnosis, she refused medical treatment because she experienced no symptoms. However, she progressively began to exhibit fatigue and loss of appetite. A computed tomography (CT) scan showed that the tumor had increased in size and was directly invading the spleen. In addition, tumor thrombosis of the left main portal branch and intrahepatic metastases to the Spiegel lobe were seen. Although the patient's liver function was defined as ‘liver damage B’, and occupied a large part of the left hepatic lobe, we determined that the tumor, was operable. We performed an extended left lobe hepatectomy and a splenectomy. Post-operatively, we administered adjuvant hepatic intra-arterial chemotherapy for close to one year. Approximately two years after the operation, the patient is still alive and well. Only two cases of hepatocellular carcinoma with direct invasion into the spleen have been previously reported in the literature. Therefore, the current case is considered to be rare, and we report this case while also reviewing the pertinent literature.