Abstract
A 90-year-old woman presented with high fever and appetite loss in September 2011. CT performed for the purpose of close exploration at another hospital disclosed a distended gallbladder and a tumor showing an extrahepatic extension, and then she was referred to our hospital. Abdominal contrast-enhanced CT scan and MRI showed an about 6-cm diameter tumor growing from the posterior inferior segment of the liver to extrahepatic area. The tumor had oppressed the gallbladder and the duodenum. Extrahepatic type non-B and non-C hepatocellular carcinoma was diagnosed and the tumor was resected together with a part of the liver. The histopathological diagnosis was moderately differentiated hepatocellular carcinoma with a simple nodular type. The background liver showed no cirrhosis findings. The postoperative course was uneventful and she was discharged from the hospital on independent gait on the 18th postoperative day.
The degree of surgical invasion must thoroughly be evaluated when we indicate hepatic resection for the extremely elderly patient. If the patient's general physical condition is favorable and the indication is strictly considered, we can select surgical resection actively even for the extremely elderly patient.
