Hepatocutaneous fistula: a complication after radiofrequency ablation therapy for hepatocellular carcinoma

A 34-year-old male was admitted for recurrent hepatocellular carcinoma (HCC) with poor healing of a radiofrequency ablation wound over the subxiphoid region. The patient underwent lobectomy of the liver 3 years previously. Transarterial chemoembolisation was performed twice for tumour recurrence, and radiofrequency ablation was done for new recurrence 2 months previously. Due to poor healing with discharge through the puncture wound and elevated alpha feto-protein (AFP) level, recurrent hepatocellular carcinoma and tumour seeding of the needle tract were suspected. During surgery, a recurrent tumour mass over segment 3 with a hepatocutaneous fistula within the adhesion tissue between the liver surface and abdominal wall was discovered. We recommend that hepatocutaneous fistula should be considered as a complication of radiofrequency ablation for hepatic tumours.