2021 Volume 54 Issue 2 Pages 98-106
A 62-year-old woman was referred to our department for further examination and treatment of 24-mm and 22-mm hypoechoic masses of the liver (S4), which were found without symptoms by US. These tumors in contrast-enhanced CT showed weak enhancement in the arterial phase and slight hypodensity compared with surrounding normal liver in the delayed phase. Furthermore, CT during arterial portography and MRI newly revealed an 8-mm tumor in the S1 segment. The tumors were diagnosed as multiple hepatocellular carcinomas and hepatectomy was performed. Left medial sectionectomy was performed because the tumor in S1 was not detected during surgery. The pathological diagnosis was mucosa-associated lymphoid tissue (MALT) lymphoma. The remaining tumor in S1 disappeared after six courses of postoperative rituximab therapy. The patient is alive without recurrence at 3 years and 9 months after hepatectomy. Primary hepatic MALT lymphoma is uncommon and a standard therapy has not been established. Surgical treatment is most common, whereas there are few previous reports of cases treated with multimodal therapy. The clinical course of our case suggests that postoperative rituximab might be effective for residual lesions of hepatic MALT lymphoma.
