Case of Recurrent Hepatocellular Carcinoma with Tumor Thrombi Formation in the Omental Vein

Abstract

An 87-year-old man underwent right posterior sectionectomy for ruptured hepatocellular carcinoma (HCC) in segment 6 of the liver ; the pathological diagnosis was moderately-differentiated HCC with microvascular invasion. A small nodule was detected on the cut end of the remnant liver 16 months after surgery. The size of the nodule rapidly increased from 1 cm to 5 cm over a period of 5 months. He was therefore referred to our hospital where he underwent partial hepatectomy.

The tumor had a capsule protruding from the caudal side of the liver, and no disseminated nodules were detected. A dilated vein with a diameter of 5 mm extending from the tumor was detected and radically resected. The tumor was histopathologically diagnosed as a poorly-differentiated HCC with tumor thrombi in the omental vein. HCCs rarely form tumor thrombi in systemic veins other than the portal vein and hepatic veins ; hence, accurate preoperative diagnosis and appropriate surgical management are required in such cases.