간세포암 파열 환자에서 단계적 간 절제술 후 광범위 조기 재발이 발생한 1예

Abstract

The rupture of hepatocellular carcinoma (HCC) has been uncommon complication. Because the diagnosis of early HCC has been increase due to development of imaging modality and surveillance program, the incidence of ruptured HCC has been decreased. The paradigm of treatment for ruptured HCC has shifted from surgical hemostasis to transcatheteric chemoembolization (TACE) at acute phase. After the control of acute phase, the definitive treatment for HCC is still debate. However, many studies have advocated staged-liver resection. Some studies reported that the patients underwent staged-liver resection showed a similar survival rate compared with survival rate in patient with non-ruptured HCC. The staged-liver resection was usually performed in the patients with well-preserved liver function. The decision of optimal time for surgery after TACE and surgical indications for ruptured HCC after any other primary treatment are controversy. We experienced a cases of early and massive recurrence HCC in patients with well-preserved liver function and the rupture of HCC. The further study may be needed to decide the optimal time of surgery after TACE and surgical indication for rutprued-HCC.