[A case of hepatocellular carcinoma resolved by hepatic resection for local treatment]

A 76-year-old man with chronic hepatitis B was found to have a liver mass during a treatment of hypertension and atrial fibrillation at his local clinic, and was hospitalized to our hospital. Laboratory results on admission showed a mild hepatic impairment (grade B) and tumor markers AFP 12 ng/mL and PIVKA-II 10,169 mAU/mL. Hepatic ultrasonography revealed a hypoechoic mass measuring 8-cm in diameter in the medial segment of the liver, and portography showed an extension of the right branch of the portal vein with no obvious tumor embolism. Hepatic arteriography disclosed an 8-cm hypervascular tumor fed by the right and left hepatic arteries. CTHA showed a high-density area between the medial and anterior segments, and the other high-density area measuring 2-cm in diameter in S5. The tumor site was observed as a portal perfusion defect area by CTAP. Hepatocellular carcinoma graded as cT3, cN0, cM0, and cStage III was diagnosed. Because the host liver function was good, hepatic resection was judged to be feasible, and the resection was performed. The postoperative course was favorable, and the patient was discharged from the hospital three weeks after surgery. It was considered that positive hepatic resection enabled radical treatment of hepatocellular carcinoma in patients with good liver function.