Case-report: Metastases in a low-stage middle-graded HCC in cleared HCV infection, non-cirrhotic liver: Surgical therapy

Stefania Brozzetti; Simone Bini; Katia Fazzi; Leonardo Luca Chiarella; Virginia Ceccarossi; Chiara De Lucia; Giorgio De Toma

doi:10.1016/j.ijscr.2018.04.013

Case-report: Metastases in a low-stage middle-graded HCC in cleared HCV infection, non-cirrhotic liver: Surgical therapy

Int J Surg Case Rep. 2018:47:19-21. doi: 10.1016/j.ijscr.2018.04.013. Epub 2018 Apr 22.

Authors

Stefania Brozzetti¹, Simone Bini², Katia Fazzi², Leonardo Luca Chiarella², Virginia Ceccarossi², Chiara De Lucia², Giorgio De Toma²

Affiliations

¹ Pietro Valdoni Surgery Department, University of Rome "La Sapienza", Rome, Italy. Electronic address: stefania.brozzetti@uniroma1.it.
² Pietro Valdoni Surgery Department, University of Rome "La Sapienza", Rome, Italy.

Abstract

Introduction: Hepatocellular carcinoma (HCC) is rare in non-cirrhotic liver. Achievement of sustained virological response (SVR) reduces even more the risk.

Presentation of case: Liver resection for small HCC was performed in cleared HCV infection non-cirrhotic 62-year-old man. Methacronous oligometastatic recurrences in intolerant to Nexavar^® side-effects patient, were treated by multiple innovative microinvasive approaches: bilateral laparoscopic adrenalectomy, thoracic wall resection, laparoscopic sacrum cryoablation combined with hadron-therapy.

Discussion: Therapies allowed the patient to lead 6 years satisfying QoL with only a small residual presacral disease stable at 8 months.

Conclusion: Microinvasive surgery may be a valid resource of therapy in indolent HCC limited distant recurrences.

Keywords: Cleared HCV; HCC metastases; Hadrontherapy; Laparoscopic malignant adrenalectomy; Mininvasive surgery.