Multiple small lesions of hepatocellular carcinoma controlled by percutaneous and laparoscopic ethanol injection - A case report

A 61-year-old man was admitted to our clinic for a liver examination. Ultra sonography revealed multiple echo-rich lesions in both lobes. A laparoscopy showed a liver with an irregular surface, and a 3-mm-sized dark reddish le sion on the inferior surface of the right lobe. alpha-Fetoprotein and plasm a protein induced by vitamin K absence or antagonist were normal. A liver b iopsy specimen obtained from, the small lesion by laparoscopy-guide showed a well-differentiated hepatocellular carcinoma with bile formation. Biopsy specimens obtained later from the 2 echo-rich lesions by ultrasonographic-g uide were histologically similar to the lesion laparoscopically observed. L aparoscopic ethanol injection and percutaneous ethanol injection were perfo rmed as therapeutic procedures. Recurrence of hepatocellular carcinoma at t he treated sites was not observed during the 6-year observation period. Thu s, laparoscopy might play an important role in the early detection and trea tment of hepatocellular carcinomas on the surface of the liver.