1990 Volume 51 Issue 7 Pages 1541-1545
A 58-year-old woman who copmplained of a weight loss and change in the sence of taste was admitted due to a large abdominal mass on the right upper quadrant. Echography, computed tomography and angiography revealed the large hepatic tumor which was fed by the right anterior inferior branch of hepatic artery. After a ligation of the right hepatic artery the tumor was extirpated by the dissection of the feeding vesgels. It showed a variety of histological features such as funicular, solid, pseudoductal, and indurated ones. After 15 months the metastases were noticed in the abdominal wall and liver, however, one of the lesions only in the abdomial wall could be extirpated. After 19 months the intrahepatic metastases became bigger and now metastasis was observed in the peritoneal cavity. After 30 months the metastses of the jejunal mesenterium was extirpated to prevent the intestinal obstruction. After 48 months she died of cahexia due to the enlarged metastatic tumors and the disturbance of the intestinal passing. This case can be classified into the protrusive type among the extrahepatic growing type of hepatocellular carcinomas according to the classification by Ichikawa. It can be said rare in the survival period for as long as 4 years that is the longest one among 62 cases of this classification reported in Japan.
