[Necrosis of the hepatocellular carcinoma nodule can aggravate metastasis]

Since the stroma of hepatocellular carcinoma is composed of sinusoid-like structures, cancer cells are readily released from the primary tumor with possible injurious consequences. A 63-year-old woman with hepatocellular carcinoma underwent percutaneous ethanol injection therapy. During this treatment, tumor thrombus developed in the right hepatic vein. Partial hepatic resection was performed. Six months later, multiple nodules appeared in the lung fields. Partial necrosis may have allowed the release of cancer cells from the primary tumor. Perioperative therapy should have an effect on intrahepatic micrometastases, because removal of the main tumor can be done surgically.