Abstract
An 82-year-old man with a history of chronic hepatitis C, cirrhosis, and hepatocellular carcinoma (HCC) had undergone percutaneous radiofrequency ablation (RFA) 6 years previously. He was now evaluated for a right-sided chest wall mass that he first noticed 2 years previously, had gradually enlarged, and was painful and bleeding. Examination showed a child-head-sized tumor with partial surface necrosis, ulceration, and bleeding. The patient had difficulty turning in a right lateral decubitus position. The mass was in the area of the prior RFA needle tract. A chest wall metastasis due to RFA needle tract implantation was diagnosed.
The tumor had progressed, causing some displacement between the ribs, but there was no exposure in the thoracic cavity or abdominal cavity. To improve the patient's quality of life (QOL), chest wall tumor resection and partial thickness skin grafting were performed. The patient's QOL was improved after surgery. In cirrhosis and HCC patients with an otherwise fair prognosis, resection of RFA needle tract chest wall metastases should be considered to prevent decreased QOL.
