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Volume 4(1); June 2004
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Review Articles
Arterioportal Shunt in Transcatheter Arterial Chemoembolization of Hepatocellular Carcinoma
Jin Wook Chung
Journal of the Korean Liver Cancer Study Group. 2004;4(1):1-6.   Published online June 30, 2004
  • 315 Views
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Well-differentiated Samll Hepatocellular Carcinoma, Early Hepatocellular Carcinoma and Dysplastic Nodule
Young Nyun Park
Journal of the Korean Liver Cancer Study Group. 2004;4(1):7-11.   Published online June 30, 2004
  • 349 Views
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Postoperative Early Multinodular Intrahepatic Recurrence of Hepatocellular Carcinoma
Jeong Ho Park, Kwang Cheol Koh
Journal of the Korean Liver Cancer Study Group. 2004;4(1):12-15.   Published online June 30, 2004
  • 383 Views
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Case Reports
Arterioportal Shunt in Hepatocellular Carcinoma
Jung Won Yun, Yong Kyun Cho, Byung Ik Kim
Journal of the Korean Liver Cancer Study Group. 2004;4(1):16-19.   Published online June 30, 2004
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AbstractAbstract PDF
Arterioportal shunt is an important hemodynamic alteration in the liver, may cause severe portal hypertension, consequently ascites, esophageal varix, or accelerating intra- and/or extravascular metastasis of carcinoma cells. Understanding of these findings will contribute to the diagnosis and prognosis of the disease and improve therapeutic efficacy for the patients. We report a case of hepatocellular carcinoma with arterioportal shunt, which was difficult to treatment.
Treatment of Hepatocellular Carcinoma with Arterioportal Shunt after Percutaneous Needle Biopsy
Sang-Hyung Cho, Jae-Hee Cheon, Hong-Suk Park, Seong-Hoon Kim, Sang-Jae Park, Woo-Jin Lee, Eun-Kyung Hong, Joong-Won Park, Chang-Min Kim
Journal of the Korean Liver Cancer Study Group. 2004;4(1):20-23.   Published online June 30, 2004
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AbstractAbstract PDF
A 51-year-old male was referred to our hospital for further evaluation and treatment of a liver mass. He was a heavy alcoholic. Laboratory findings revealed that anti-HCV was positive, and AFP is below 400 ng/mL. We performed CT scan that showed multiple nodules in the right lobe. Among them, the nodule in the segment Ⅷ showed incomplete enhancement at the arterial phase. Hence, we performed percutaneous needle biopsy for this nodule, and pathologically proved to hepatocellular carcinoma of Edmonson-Steiner grade Ⅱ/Ⅳ. We performed transcatheter arterial chemoembolization(TACE) for multiple hepatocellular carcinomas. Angiography showed nodular tumor staining and arterioportal shunt and arteriovenous shunts at the biopsy site in the segment Ⅷ. We occluded the shunts by using Lipiodol and gelform mixtures and then performed TACE. After TACE, angiography did not show either residual tumor staining or arterioportal and arteriovenous shunts.
Successful Retreatment by Transcatheter Arterial Chemoembolization after Radiotherapy for Hepatocellular Carcinoma with Arterioportal Shunt: A Case Report
Tae Wook Kang, Moon Suk Choi, Seung Woon Paik, Joon Hyuk Lee, Kwang Cheol Koh, Byung Cheol Yoo
Journal of the Korean Liver Cancer Study Group. 2004;4(1):24-28.   Published online June 30, 2004
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AbstractAbstract PDF
It is known to be difficult to manage hepatocellular carcinoma with shunt by using transcatheter arterial chemoembolization due to retention failure of the chemotherapeutic agent to the target site. Recently we experienced a patient having hepatocellular carcinoma with arterioportal shunt who could undergo effective transcatheter arterial chemoembolization after radiotherapy.
Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma with Arterioportal Shunt : A Report of One Case
Sang Kyun Yu, Soon Ho Um, Cheol Young Kim, Sung Bum Cho, Nam Hee Won
Journal of the Korean Liver Cancer Study Group. 2004;4(1):29-32.   Published online June 30, 2004
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AbstractAbstract PDF
Transcatheter arterial chemoembolization(TACE) is an effective treatment method in the management of patients with inoperable hepatocellular carcinoma. The effectiveness of TACE, however, is decreased, when arterioportal shunt is present, since embolic and chemotherapeutic agents are diverted from the tumor to the normal parenchyma through branches of the portal vein. In such case, TACE may not only be ineffective, but also cause hepatic infarction followed by hepatic failure. We report a case of hepatocellular carcinoma with arterioportal shunt, successfully treated by TACE.
A Resected Case of Early Hepatocellular Carcinoma
Sang-Jae Park, Joong-Won Park, Seong-Hun Kim, Soon-Ae Lee, Young-Hun Kim, Eun-Kyoung Hong, Chang-Min Kim
Journal of the Korean Liver Cancer Study Group. 2004;4(1):33-38.   Published online June 30, 2004
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AbstractAbstract PDF
A 35 year-old male patient admitted due to epigastric pain for 1 month. He was heavy drinker and spider angioma was obserbed in physical examination. HBsAb, anti-HBs Ab and anti-HCV Ab were all negative and AFP level was normal. AST/ALT were elevated to 178 IU/L and 107 IU/L, respectively. At ultrasonography, CT and MRI, a 2 cm, hypervascular mass was detected in the segment Ⅵ. Segmentectomy of the segment Ⅵ was performed. Tumor size 1.7 cm in maximum diameter and the Edmondson and Steiners grade Ⅰ. High-grade dysplasia was present in the periphery of hepatocellular carcinoma (nodule-in-nodule). Microvascular invasion was not observed and background liver was cirrhotic. He was discharged 10 days after operation without any problem and there has been no evidence of recurrence for the 2 years postoperatively.
A Case of Surgically Diagnosed, Small Hepatocellular Carcinoma with Well-differentiated Type
seung-Seok Ki, Duck-Ryung Kim, Sook-Hyang Jeong, Chul-Ju Han, Jin Kim, Yu-Cheol Kim, Jin-Oh Lee, Sang-Beom Kim, Dong-Wook Choi, Young Han Kim, Dong-Hee Park, Byung-Hee Lee, Sun-Hoo Park
Journal of the Korean Liver Cancer Study Group. 2004;4(1):39-41.   Published online June 30, 2004
  • 366 Views
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AbstractAbstract PDF
The diagnosis of small hepatocellular carcinoma(HCC) of well-differentiated type is not always easy and is often problematic in clinical practice. Hepatic resection provides excellent survival for well-differentiated HCC. We report a case of small HCC with well-differentiated type, which was surgically diagnosed, in a 47-year-old man.
A Case of High-grade Dysplastic nodule Mimicking Well-differentiated Hepatocellular Carcinoma
Dong Hee Kim, Seung Woon Paik, Moon Seok Choi, Joon Hyuk Lee, Kwang Cheol Koh, Byung Cheol Yoo
Journal of the Korean Liver Cancer Study Group. 2004;4(1):42-45.   Published online June 30, 2004
  • 684 Views
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AbstractAbstract PDF
The differential diagnosis of small nodular lesion arising in cirrhosis is basically restricted to early hepatocellular carcinoma(HCC) and non-malignant macronodules including large regenerative, low-and high-grade dysplastic nodules. Especially, differentiation of HCC from high-grade dysplasia is a well-recognized problem. Here we describe an unusual case of high-grade dysplasia which mimicks HCC. A 3 cm, hepatic mass was detected in a 47-year-old man with chronic hepatitis during abdominal sonography. Differential diagnosis was difficult with laboratory and radiological studies. It was proved to be a high-grade dysplasia after surgical resection.
Poorly-differentiated Carcinoma in Well-differentiated Hepatocellular Carcinoma (Nodule-in-nodule) and Concurrent Moderately-differentiated Hepatocellular Carcinoma: A Case Report
Sang Kyun Yu, Soon Ho Um, Yoon Hwan Kim, Nam Hee Won
Journal of the Korean Liver Cancer Study Group. 2004;4(1):46-49.   Published online June 30, 2004
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AbstractAbstract PDF
Extensive studies on early stage hepatocellular carcinomas (HCCs) have defined its pathomorphologic features. Most early HCCs are well-differentiated and an ill-defined nodular appearance. Proliferation of well-differentiated, small HCCs is closely related to tumor size of 1.0-1.5 cm in diameter. Furthermore, less differentiated cancerous tissues with greater proliferative activity can evolve within ti. Such a phenomenon is often appreciated grossly and/or histologically, and is called as a "nodule in nodule" appearance. We report a case of poorly-differentiated carcinoma in well-differentiated hepatocellular carcinoma (nodule-in-nodule) and concurrent moderatedly-differentiated hepatocellular carcinoma.
Small Hepatocellular Carcinoma in Dysplastic Nodule
Chang Wook Kim, Eun Sun Jung, Jong Young Choi, Jeong Won Jang, Si Hyun Bae, Seung Kew Yoon, Chang Don Lee, Kyu Won Chung, Hee Sik Sun
Journal of the Korean Liver Cancer Study Group. 2004;4(1):50-54.   Published online June 30, 2004
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AbstractAbstract PDF
Dysplastic nodule (DN) is considered as precancerous lesion of hepatocellular carcinoma (HCC). There are several evidences to support the theory about multistep progression of hepatocarcinogenesis. Recently we experienced a patient with HCC of the odule-in-nodule pattern, namely small HCC within DN, which supported the multistep theory of hepatocarcinogenesis. The tumor was seen as a 3 cm, arterial enhancing mass with delayed wash-out patterns in the segment Ⅶ at helical CT. The patient was treated by surgical resection. A 3.0×2.5 cm mass was seen in the resected specimen. A 2.2×1.5 cm, smaller nodule was observed within this mass, i.e. the odule-in-nodule pattern. Microscopically, various grades of HCC foci were seen within high grade DN. Because DN does not always progress to HCC, further studies are needed to evaluate what kind of DN has the high possibility of progressing of HCC at last.
A Case of Early Recurrence of Hepatocellular Carcinoma after Curative Hepatic Resection
Sang-Hyung Cho, Jae-Hee Cheon, Hong-Suk Park, Seong-Hoon Kim, Sang-Jae Park, Woo-Jin Lee, Eun-Kyung Hong, Joong-Won Park, Chang-Min Kim
Journal of the Korean Liver Cancer Study Group. 2004;4(1):55-58.   Published online June 30, 2004
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AbstractAbstract PDF
A 52-year-old male was referred to our hospital for further evaluation and treatment of known hepatocelluar carcinoma. He did not have risk factors for hepatocellular carcinoma, such as hepatitis virus infection, alcohol abuse and occupational history. We performed CT scan that showed a single nodule with a diameter of 4 cm in the segment Ⅴ. MR imaging showed the same nodule in the segment Ⅴ without any additional nodule in the liver. We performed segmentectomy for the segment Ⅴ, Ⅵ, and Ⅶ. Five months later, follow-up CT scan showed disseminated hypervascular nodules involving the remaining liver. Hepatic angiography also showed multiple hypervascular nodules in the remaining liver, indicating early recurrence by intrahepatic metastasis. We then performed transcatheter arterial chemoembolization (TACE). At present, this patient underwent TACE for ten times, but was still found to have new intrahepatic metastases, tumor invasion to the portal vein and lymph node metastasis in the peripancreatic area.
A Case of Early, Widespread Intrahepatic Recurrence of Hepatocellular Carcinoma after Surgical Resection
Seung-Seok Ki, Duck-Ryung Kim, Sook-Hyang Jeong, Chul-Ju Han, Jin Kim, Yu-Cheol Kim, Jin-Oh Lee, Sang-Beom Kim, Dong-Wook Choi, Young Han Kim, Dong-Hee Park, Byung-Hee Lee, Sun-Hoo Park
Journal of the Korean Liver Cancer Study Group. 2004;4(1):59-61.   Published online June 30, 2004
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AbstractAbstract PDF
Liver resection is the major curative treatment modality for hepatocellular carcinoma(HCC). However, postoperative intrahepatic recurrence is common and remains the main obstacle to long-term cure. Although small HCC without vascular invasion showed more than 50 % of 5-year survival rate, some patients with HCC at early stage cannot attain long-term survival after hepatectomy. We report here a case of stage Ⅰ HCC in a 64-year-old man showing early, widespread intrahepatic metastasis at 4 months after resection.
A Case of Early Multiple Recurrences After Hepatectomy with Lymph Node Dissection in Hepatocellular Carcinoma with Lymph Node Metastasis
Byoung Kuk Jang, Ki Min Kwun, Woo Jin Jung, Kyung Sik Park, Kwang Byum Jo, Jae Suk Hwang, Seong Hoon Ahn, Ku Jung Kang, Jung Hyuk Kwun
Journal of the Korean Liver Cancer Study Group. 2004;4(1):62-66.   Published online June 30, 2004
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AbstractAbstract PDF
A 52-year-old man who underwent left hepatectomy with lymph node dissection due to hepatocellular carcinoma with lymph node metastasis. After 5 months of surgery, multiple recurrences were founded throughout the liver, lung, bones and intraperitoneal lymph nodes. The patient died of liver failure after rupture of recurrent hepatic tumor. From our experience, we reaffirmed that the prognosis of patients with nodal metastasis from hepatocellular carcinoma was generally poor, even after hepatic resection with lymph node dissection was performed.

JLC : Journal of Liver Cancer