Abstract

Recurrence in remnant liver originates from intrahepatic metastasis(IM) from the primary resected tumor or from multicentric occurrence(MO). These two recurrent patterns are completely different and survival after treatment is also different. At present, most surgeons accept a repeated hepatectomy for recurrent HCC is the effective treatment modality. We encountered a recurrent hepatocellular carcinoma by multicentric occurrence in a 49-year-old woman. At first operation, we performed segmentectomy of 7. The tumor was 1cm sized yellowish to gray color mass. Histologically, the tumor was Edmondson-Steiners Grade Ⅱ with trabecular and nodular type of HCC. After 14 months of initial hepatectomy, recurrent tumor staining were detected by angiogram in seg. 6 and 8. We performed the wedge resections of seg. 6 and 8. The tumor of seg. 8 was Edmondson-Steiners grade Ⅰ-Ⅱ with trabecular HCC, and seg. 6 was a very unusual histologic variant of HCC. After 7 months of 2nd hepatectomy, APF was increased 173,7 ng/mL. Arterial angiography revealed small nodule supplied by 4 branch of hepatic artery. We performed the repeat wedge resection of seg. 4. Histologically, the tumor was Edmondson-Steiners Grade Ⅱ with trabecular pattern HCC. The patient is alive and disease-free 6 months after the 3rd operation.

• Keywords: Recurrence;Multicentric occurrence;Hepatocellular carcinoma