alexa Long Survival in a Rare Case of Hepatocellular Carcinoma that Metastasized to the Ovary: A Case Report
ISSN: 2165-7920

Journal of Clinical Case Reports
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Case Report

Long Survival in a Rare Case of Hepatocellular Carcinoma that Metastasized to the Ovary: A Case Report

Akimasa Fukui1*, Kimio Ushijima1, Shin Nishio1, Keizo Fujiyoshi1, Masayoshi Kage2 and Toshiharu Kamura1
1Department of Obstetrics and Gynecology, Kurume University School of Medicine, Japan
2Department of Pathology, Kurume University School of Medicine, Japan
Corresponding Author : Akimasa Fukui
Department of Obstetrics and Gynecology
Kurume University School of Medicine
67, Asahimachi, Kurume, Fukuoka, 830-0011, Japan
Tel: +81-942-31-7573
Fax: +81-942-35-0238
E-mail: [email protected]
Received November 17, 2012; Accepted January 23, 2013; Published January 25, 2013
Citation: Fukui A, Ushijima K, Nishio S, Fujiyoshi K, Kage M (2013) Long Survival in a Rare Case of Hepatocellular Carcinoma that Metastasized to the Ovary: A Case Report. J Clin Case Rep 3:249. doi:10.4172/2165-7920.1000249
Copyright: © 2013 Fukui A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
 

Abstract

Hepatocellular carcinoma usually metastasizes to the lung, bone, adrenal glands, diaphragm and lymph nodes. In this study, we present a case of hepatocellular carcinoma that metastasized to the ovary. To the best of our knowledge, there are very few reports of such cases published in English and none in which the patient survived more over 7 years. A 72-year-old postmenopausal Japanese woman had been diagnosed with type C chronic hepatitis. Screening ultrasonography revealed a low echoic small nodular lesion located on S6 of the liver. Tiny hepatocellular carcinoma was diagnosed by needle biopsy and the patient was treated with percutaneous ethanol injection therapy. Two years later, she underwent a work-up because of an elevation in serum alpha-fetoprotein level, and whole body Computed Tomography scan revealed a large solid pelvic mass. At laparotomy, a large right ovarian tumor was revealed. No other lesion was found. A bilateral salpingo-oophorectomy was performed. On microscopic examination, the tumor showed predominantly solid and trabecular patterns. Pseudo-glandular patterns were also observed. The final pathological diagnosis was hepatocellular carcinoma metastatic to the right ovary. Postoperatively, the serum alphafetoprotein concentration decreased to within the normal range. Although, we resected an implantation in her right thoracic wall seven months post laparotomy, she did not show any evidence of recurrence during her 7 year follow up period. Metastatic hepatocellular carcinoma to the ovary is very rare. If a patient presents with findings similar to those describing our patient, the examining physician should be aware of the risk of potential ovarian metastases from hepatocellular carcinoma. Surgical resection may be the only effective treatment strategy for static ovarian cancer.

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