A POSSIBLE PROTOTYPE OF MULTIFOCAL RECURRENCE AFTER LIVER RESECTION OF HEPATOCELLULAR-CARCINOMA - REPORT OF A CASE

The clinical course of a 68-year-old male with HCC is herein reported. In addition to two tumor nodules detected preoperatively, the resecte d surgical specimen disclosed macroscopically invisible tumor-cell clu sters as well as intrahepatic metastatic foci. These clusters had no c lear border and were more basophilic with small-sized cells, high cell ularity, and a higher nuclear/cytoplasm ratio, which was suggestive of early HCC with a form of de novo occurrence. The post-operative cours e, characterized by an early recurrence of small nodules in the remnan t liver suggested the presence of a similar invisible tumor mixture at the time of operation. This case can thus be regarded as a prototype of the multifocal recurrence type.