OUR EXPERIENCE WITH HUGE LIVER TUMORS

R.SHAHBAZOV, K. BEYDULLAYEV, E. AHMEDOV, A. MEMISH, C. MUSAYEV,

H. ISAYEV

Scientific Center of Surgery named after Akad Topchubashov, Central Hospital for Neftciler, Baku, AZERBAIJAN

Introduction: The surgical resection of the large liver tumors are a most challenging task in liver surgery. Giant liver tumors causing severe incapacitating symptoms are generally considered an absolute indication for surgical resection. Here, we present a case of a giant liver tumor which was successfully treated with liver resection.

Case presentation: A 56 year-old man was referred to our hospital with complaints of severe dull upper abdominal pain and distension. He had history of left side colon resection for colon cancer four years prior coming to our hospital. However, he had not followed up with checks over the following years. Physical examinations, revealed a right liver mass occupying the abdominal cavity, protruding into the right diaphragm up to the right thoracic cavity with a maximum diameter of 33 cm .Full laboratory tests, appropriate ultrasound examinations, as well as CT angiography were done. Based on the tumor size and the anatomic relationship between the tumor and hepatic vena cava , primary resection seemed difficult and dangerous, leading us to first perform transcatheter arterial embolization to reduce the tumor volume and to ensure the safety of future resection. The tumor volume was significantly decreased by successive transcatheter arterial embolizations, and preoperative volumetry has shown 600 sm² , which was considered enough for a man with body weight of 65 Kg. An extended right hepatectomy was then performed without difficulty to remove the tumor.Post operative period was uneventful and on day 6 the patient was discharged from the hospital. Regular follow up examinations have shown the patient to be recovering well..

Conclusions: To date, there have been several reports of aggressive surgical treatments, including extra-corporeal hepatic resection and liver transplantation, for huge liver tumors like the present case, but because of its suitable remnant volume, every effort should be made to avoid life-threatening surgical stress for patients. Our experience demonstrates that a pre-operative arterial embolization may effectively enable the resection of large liver tumors

Date: 2014-12-28; view: 831