Abstract
A-56-year-old Japanese man with liver cirrhosis related hepatitis C virus (HCV) was admitted to our hospital for the treatment to advanced hepatocellular carcinoma (HCC). He had been treated with transcatheter arterial chemoembolization (TACE), radiofrequency ablation (RFA) to HCC, and surgical resection to peritoneal metastasis prior to this admission. Despite of these treatments, disseminated peritoneal tumor was observed and HCC had relapsed again. Therefore we had treated this patient with systemic 5-fluorouracil and pegylated interferon-alpha (PEG-IFN/5FU) combination therapy. On the first day of 1 course, he showed severe abdominal pain, cold sweat and blood pressure decreased suddenly. High density ascites on CT and bloody ascites on puncture revealed HCC rupture. His clinical condition was stabilized followed by conservative therapy, and his HCC and disseminated peritoneal tumors had reduced apparently. Therefore, we had treated him with systemic PEG-IFN/5FU combination therapy repeatedly. After 4courses of the administration, dynamic CT demonstrated disappearance of HCC, and serum tumor markers had normalized. Although the ruptured HCC were potentially fatal, systemic PEG-IFN/5FU therapy was very effective. His condition has been well for 34 months after HCC rupture.
