Surgical removal of a distinct subcutaneous metastasis of multilocular hepatocellular carcinoma 2 months after initial percutaneous ethanol injection therapy

Z Gastroenterol. 2001 Sep;39(9):789-92. doi: 10.1055/s-2001-17188.

Abstract

Subcutaneous tumor seeding after percutaneous ethanol injection therapy (PEI) for hepatocellular carcinoma is a rarely seen complication. It is reported due to needle track seeding during PEI after a distance of 6-46 months. Metastatic tumor spread is described subcutaneously, to the chest wall, abdominal wall and diaphragm. We report the case of a 76-year-old patient with chronic hepatitis B infection and cirrhosis which let to a multilocular hepatocellular carcinoma who underwent PEI. This patient developed 2 months after primary PEI a subcutaneous tumor formation confined to the right lower chest wall. Surgical tumor resection was performed. The histopathological evaluation confirmed subcutaneous seeding of the preknown hepatocellular carcinoma with a maximum of 30 mm in diameter. As a risk of PEI subcutaneous metastasis of the primary tumor should be considered even in early stage of therapy and close follow-up of the patient during treatment is required. Surgical tumor resection to ensure the curative intention of PEI is advisable.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Carcinoma, Hepatocellular / drug therapy
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / secondary*
  • Carcinoma, Hepatocellular / surgery*
  • Dermatologic Surgical Procedures
  • Ethanol / administration & dosage*
  • Follow-Up Studies
  • Humans
  • Liver Neoplasms / drug therapy
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery*
  • Male
  • Neoplasm Seeding*
  • Skin / pathology
  • Skin Neoplasms / pathology
  • Skin Neoplasms / secondary*
  • Skin Neoplasms / surgery

Substances

  • Ethanol