Laparoscopic Hepatectomy for Hepatocellular Carcinoma with Severe Aplastic Anemia—A Case Report—

Abstract

A 72-year-old man was diagnosed with aplastic anemia in his thirties and thereafter had received a periodic blood transfusion. A liver mass in the lateral segment was incidentally pointed out by a plain computed tomography (CT). Contrast-enhanced CT could not be performed due to his allergy to contrast media. He was diagnosed with hepatocellular carcinoma (HCC) by a liver biopsy. In this case, we considered the surgical risk to be extremely high due to severe pancytopenia. This patient could not be a candidate for radiofrequency ablation and hepatic artery embolization because the maximum tumor diameter was 3.0 cm and he was allergic to contrast media. After discussions with hematology and gastroenterology professions, we decided to perform laparoscopic lateral hepatectomy after a planned platelet transfusion. The patient was discharged home from the hospital after the surgery without major complications. The patient has had good postoperative course with no evidence of recurrence as of 16 months after the operation. The patients with HCC with aplastic anemia can pose some perioperative problems such as anemia, bleeding tendency, and susceptibility to infection. However, they can be treated by appropriate perioperative management in cooperation with related departments and reduction of the bleeding risk by selecting laparoscopic hepatectomy.