Abstract

A 59-year-old male patient visited ER complaining of persistent pain in his right upper quadrant abdomen. He had suffered from end stage renal disease secondary to long-term hypertension and had been under the maintenance hemodialysis for 13 years. Half a month ago, he recognized a mass at his epigastric area. He did not have any history of liver disease in his lifetime. Physical exams revealed that he had a tender and hard mass on his right upper quadrant and epigastric area. Total bilirubin was 0.6 mg/dL, AST/ALT was 59/75 IU/L, and AFP was 105,740 ng/mL. Computed tomography showed the huge liver mass in the left lobe and its size was estimated about 16cm. The regional lymph node was also found in the porta hepatis area. He received complete resection of the hepatoma and was discharged. We concerned about high probability of recurrence because of the pre-operative AFP level and vascular invasion in the pathologic specimen.

• Keywords: Massive hepatocellular carcinoma;Resection;Vascular invasion