Hepatocellular carcinoma with duodenal invasion resected subsequent to multimodal therapies: A case report.
Case report
Duodenal invasion
Hepatectomy
Hepatocellular carcinoma
Pancreas-preserving partial duodenectomy
Sorafenib
Journal
International journal of surgery case reports
ISSN: 2210-2612
Titre abrégé: Int J Surg Case Rep
Pays: Netherlands
ID NLM: 101529872
Informations de publication
Date de publication:
2019
2019
Historique:
received:
15
05
2019
revised:
21
06
2019
accepted:
21
06
2019
pubmed:
10
7
2019
medline:
10
7
2019
entrez:
9
7
2019
Statut:
ppublish
Résumé
Gastrointestinal (GI) involvement in hepatocellular carcinoma (HCC) is uncommon. In particular, HCC with duodenal invasion is known to be a rare condition. In such cases, surgical indication has been generally negative except in few reported cases. To our knowledge, this report describes the first case of HCC with duodenal invasion, resected by hepatectomy accompanied by pancreas-preserving partial duodenectomy (HPPD) following multimodal therapies including systemic sorafenib administration. A 65-year-old man had been repeatedly treated for multiple HCCs by transarterial chemoembolization (TACE) and sorafenib. However, the main tumor formerly ruptured began to involve his duodenum, causing GI bleeding. The collateral vessels from the pancreatic and omental branches entered the tumor and nullified the transarterial hemostatic embolization. Hence, HPPD was performed to preserve the major Vater papilla. Histopathological examination revealed poorly-to -moderately differentiated HCC cells invading the duodenum. HPPD treatment successfully removed HCC with duodenal invasion achieving viable tumor clearance status (R0). We underline the importance of achieving viable tumor clearance status at any time during the treatment course of patients with advanced HCC as this approach may be the only approach to enable HCC patients with duodenal invasion to resume a healthy life.
Identifiants
pubmed: 31284223
pii: S2210-2612(19)30359-1
doi: 10.1016/j.ijscr.2019.06.046
pmc: PMC6614111
pii:
doi:
Types de publication
Journal Article
Langues
eng
Pagination
348-352Informations de copyright
Copyright © 2019 The Author(s). Published by Elsevier Ltd.. All rights reserved.
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