Long-term survival of 11 years with multidisciplinary therapy for hepatocellular carcinoma metastasis to the ovary and peritoneum: a case report.


Journal

Clinical journal of gastroenterology
ISSN: 1865-7265
Titre abrégé: Clin J Gastroenterol
Pays: Japan
ID NLM: 101477246

Informations de publication

Date de publication:
Aug 2021
Historique:
received: 04 02 2021
accepted: 02 05 2021
pubmed: 13 5 2021
medline: 27 7 2021
entrez: 12 5 2021
Statut: ppublish

Résumé

We herein report a rare case of HCC metastases to the ovary and peritoneum in a 61-year-old female patient who has achieved 11-year survival with multidisciplinary therapy. The patient was diagnosed with HCC during balloon angioplasty performed for Budd-Chiari syndrome in 1994 and underwent partial hepatectomy twice. Five years after the second hepatectomy, allochronic recurrence of a single nodule detected in S8 was treated by radiofrequency ablation, followed by percutaneous ethanol injection therapy and stereotactic body radiotherapy. However, her α-fetoprotein level rose to 1862 ng/mL within one year and computed tomography revealed a large pelvic tumor suggesting HCC metastasis to the ovary. The subsequent laparotomy revealed one 11-cm left ovarian tumor, one small right ovarian nodule, and numerous peritoneal nodules. Bilateral salpingo-oophorectomy and peritoneal resection of as many nodules as possible were performed. Combination therapy with intravenous 5-fluorouracil plus cisplatin and ramucirumab monotherapy effectively suppressed tumor progression with maintenance of hepatic functional reserve, and she has achieved long-term survival of 11 years, illustrating that multidisciplinary therapy with favorable hepatic functional reserve maintenance can contribute to long-term survival in HCC with extrahepatic spread.

Identifiants

pubmed: 33978943
doi: 10.1007/s12328-021-01434-2
pii: 10.1007/s12328-021-01434-2
pmc: PMC8298212
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1211-1220

Informations de copyright

© 2021. The Author(s).

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Auteurs

Satoko Motegi (S)

Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan.

Takeshi Yokoo (T)

Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan. t-yokoo@med.niigata-u.ac.jp.
Department of Preemptive Medicine for Digestive Diseases and Healthy Active Life, School of Medicine, Niigata University, Niigata, Niigata, Japan. t-yokoo@med.niigata-u.ac.jp.

Ryosuke Nozawa (R)

Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan.

Rie Azumi (R)

Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan.

Yuzo Kawata (Y)

Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan.

Kohei Ogawa (K)

Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan.

Toru Setsu (T)

Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan.

Ken-Ichi Mizuno (KI)

Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan.

Koji Nishino (K)

Department of Obstetrics and Gynecology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan.

Hajime Umezu (H)

Division of Pathology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan.

Hirokazu Kawai (H)

Department of Internal Medicine, Niigata Prefectural Shibata Hospital, Shibata, Niigata, Japan.

Takeshi Suda (T)

Department of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine Niigata University Hospital, Minamiuonuma, Niigata, Japan.

Shuji Terai (S)

Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan.

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