A case of pseudoaneurysm formed 10 years after segmental liver resection for hepatocellular carcinoma

Abstract

A 73-year-old man with chronic hepatitis C was diagnosed as hepatocellular carcinoma in segment 5 of the liver. Then anterior segmental liver resection was performed in 1999. He was checked by abdominal US or CT every 4-6 months after resection. In March 2009, abdominal CT showed a heterogeneous lesion with partially enhanced area at the right hepatic lobe after the resection. The lesion had enlarged with follow up CT in May 2009, and was diagnosed as pseudoaneurysm. Abdominal angiography showed a hepatic arterial pseudoaneurysm, 3 cm in diameter originating from the anterior segmental branch. The pseudoaneurysm was embolized using microcoils for prevention of rupture.
The risk of rupture of pseudoaneurysm and mortality after rupture were very high. Therefore, earlier treatment might be preferable. Patients who have performed liver resection should be carefully followed up for not only detection of HCC recurrence but that of possible pseudoaneurysm as a late complication.