Journal of Liver Cancer

Ji Young Lee

2 Articles

Two Cases of Spontaneous Bacterial Peritonitis Developed Right after Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma: Jung Hoon Lee, Joo Hyun Sohn, Tae Yeob Kim, Ji Young Lee, Ki Sul Chang, Dong Hoon Lee, Eun Sik Park; Journal of the Korean Liver Cancer Study Group. 2013;13(2):145-151. Published online September 30, 2013; DOI: https://doi.org/10.17998/jlc.13.2.145

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Abstract PDF: Although acute hepatic failure (AHF) after transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) is not a rare complication, the development of spontaneous bacterial peritonitis (SBP) is uncommon. We describe two cases who suffered SBP and AHF right after TACE for HCCs. In the first case, 5 days after TACE ascites and jaundice newly developed and SBP was diagnosed at 9 days after TACE. After use of secondary antibiotics (imipenam) due to failure of primary therapy with 3rd cephalosporin, he discharged with resolution of SBP. In the second case, jaundice, abdominal pain and fever developed with increased ascites 3 days after TACE. After 8 days, SBP was diagnosed and treated with imipenam due to primary treatment failure, but clinical course was deteriorated. Eighteen days after discharge, she died of AHF. In patients with increased ascites and fever after TACE, clinician should be considered SBP with AHF among post-TACE complications, and prompt management is needed.

A Case of Primary Parasternal Abscess in a Cirrhotic and Diabetic Patient with Hepatocellular Carcinoma: Ji Young Lee, Joo Hyun Sohn, Tae Yeob Kim, Jung Hoon Lee, Ki Sul Chang, Hye Young Lee, Hyo Young Lee; Journal of the Korean Liver Cancer Study Group. 2013;13(2):164-168. Published online September 30, 2013; DOI: https://doi.org/10.17998/jlc.13.2.164

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Abstract PDF: Parasternal abscess is usually related to cardiac surgery, trauma or IV drug use and curable with antibiotics and surgical drainage. Sternal metastasis or primary parasternal abscess in a patient with hepatocellular carcinoma (HCC) is much rare and the differentiation between two diseases is occasionally difficult. Herein, we report a patient with HCC, diabetes mellitus and a spontaneously occurred parasternal abscess that is initially confused with a sternal metastasis. A-57-year-old man was admitted due to a slowly growing parasternal mass for 2 months. Two years prior to the admission, he had been diagnosed with small (1.6 cm) HCC in segment VII related to chronic hepatitis Band liver cirrhosis and treated with radiofrequency thermal ablation (RFTA). One year after RFTA, small (1.7 cm) HCC recurred in segment I and then he received TACE twiceat interval of 2 months. Eight months after that, multinodular HCCs newly developed in segment V and VIII (TNM stage IIIA) and two times of additional TACE were given. Thereafter he complained of gradually protruding mass with focal redness and mild tenderness on the sternum. But he denied any febrile and chilling sensation. Dynamic CT scans showed an enhanced parasternal lesion with bone destruction, while a bone scan displayed an increased uptake in the same site, resulting in an indistinguishable lesion between an abscess and a sternal metastasis of HCC. An excisional biopsy was performed on the lesion and revealed an abscess with sternal osteomyelitis rather than sternal metastasis. It was cured with surgical excision and antibiotics without complications.