A LONG-TERM SURVIVOR OF RUPTURED HEPATOCELLULAR-CARCINOMA AFTER HEPATIC RESECTION

We treated a patient who had previously undergone a hepatic resection for ruptured hepatocellular carcinoma (HCC) but developed a solitary p eritoneal recurrence at the site of the incision 8 years and 9 months later. Since no other recurrence was evident, we resected the tumour. The primary tumour was 2.5 cm in size and histological examination rev ealed HCC without any histological risk factors for intrahepatic recur rence. The peritoneal tumour consisted of less differentiated cancer c ells than those found in the primary tumour. The positive rates of Ki- 67 were 10% in the primary tumour and 23.3% in the peritoneal recurren ce. The DNA indexes in both rumours were considered to be identical. T he comparison between the primary and peritoneal rumours suggested tha t the histological differentiation and proliferation activity can chan ge after recurrence, in spite of consistent DNA ploidy contents. Clini cally, a patient who undergoes a hepatic resection for ruptured HCC ca n survive for a long time, such as 10 years, if they have good liver f unction and small HCC without any histological risk factors for intrah epatic recurrence. However, since late recurrence is possible, a follo w up for as long as 10 years is recommended.