Brain metastasis of hepatocellular carcinoma detected after liver transplantation

França, Alex Vianey Callado; Martinelli, A.L.C.; Silva, Orlando Castro e

doi:10.1590/s0004-28032004000300012

Cited by 10 publications

(10 citation statements)

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“…bones, adrenal glands, and lungs. 6,11 In our patient, metastasis may have occurred before the liver transplant, which is consistent with the early elevation of the serum AFP level after surgery and the patient's status of HCC beyond the Milan criteria. Fanca et al have suggested that immunosuppression may increase the growth rate of tumors.…”

Section: Discussionsupporting

confidence: 83%

“…Central nervous system (CNS) metastasis of HCC is also reported to be rare, 5 especially in post-liver-transplant patients. 11 Intracranial metastasis of HCC is known to be associated with hemorrhage because metastatic lesions from HCC are hypervascular, and most patients have coagulopathy due to liver cirrhosis, leading these patients to manifest stroke-like events. 14 In general, the operative indications for metastatic brain tumors are as follows: (1) symptomatic disease, (2) a solitary tumor, (3) a feasible operative site, (4) the primary lesion can be cured, and (5) significantly long remission is expected.…”

Section: Discussionmentioning

confidence: 99%

“…2,[7][8][9][10] However, posttransplant tumor recurrence is observed in approximately 8% to 11% of selected patients, with frequent relapses observed in the implanted liver, bones, adrenal glands, and lungs. 6,11 Metastases in the mediastinum and central nervous system are very rare, especially post liver transplantation. 11 We herein describe the case of a patient who developed metachronous mediastinal and intracranial metastasis of HCC after undergoing liver transplantation.…”

mentioning

confidence: 99%

“…6,11 Metastases in the mediastinum and central nervous system are very rare, especially post liver transplantation. 11 We herein describe the case of a patient who developed metachronous mediastinal and intracranial metastasis of HCC after undergoing liver transplantation.…”

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confidence: 99%

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Two Rare Metachronous Metastases of Hepatocellular Carcinoma After Liver Transplantation

Shinya

Noritomi

Yamauchi

et al. 2013

International Surgery

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A 59-year-old male with hepatocellular carcinoma (HCC) due to liver cirrhosis caused by the hepatitis C virus underwent cadaveric whole liver transplantation. Two years later, he had a metastatic HCC in the superior mediastinum. Over the following postoperative year, he underwent transcatheter arterial chemoembolization (TACE) for 4 tumors in the implanted liver. In the third post-TACE month, he was emergently hospitalized due to intracerebral hematoma with a tumor invading the bone in the medial frontal segment. He underwent emergency intracranial tumorectomy and hemorrhage removal. The histopathologic diagnosis was metastatic HCC. He regained consciousness as well as the ability to speak and to feed himself, resulting in an improved quality of life. The incidence of HCC recurrence after liver transplantation is observed in approximately 8% to 11% of selected cases, with frequent relapses observed in the implanted liver, bones, adrenal glands, and lungs. Mediastinal and intracranial metastases from HCC post-liver transplantation are very rare.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Two Rare Metachronous Metastases of Hepatocellular Carcinoma After Liver Transplantation

Shinya

Noritomi

Yamauchi

et al. 2013

International Surgery

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“…Thus, it is imperative to perform bone scin- tigraphy and chest and abdomen tomography to rule out tumor dissemination. Although uncommon, brain metastasis may occur (33). For patients who benefit from radical or curative treatment, mainly liver transplantation, we believe that skull tomography should be performed routinely to ex- Table 3.…”

Section: T1mentioning

confidence: 99%

Diagnosis, staging and treatment of hepatocellular carcinoma

França

Elías

Lima

et al. 2004

Braz J Med Biol Res

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Hepatocellular carcinomas are aggressive tumors with a high dissemination power. An early diagnosis of these tumors is of great importance in order to offer the possibility of curative treatment. For an early diagnosis, abdominal ultrasound and serum alpha-fetoprotein determinations at 6-month intervals are suggested for all patients with cirrhosis of the liver, since this disease is considered to be the main risk factor for the development of the neoplasia. Helicoidal computed tomography, magnetic resonance and/or hepatic arteriography are suggested for diagnostic confirmation and tumor staging. The need to obtain a fragment of the focal lesion for cytology and/or histology for a diagnosis of hepatocellular carcinoma depends on the inability of imaging methods to diagnose the lesion. Several classifications are currently available for tumor staging in order to determine patient prognosis. All take into consideration not only the stage of the tumor but also the degree of hepatocellular dysfunction, which is known to be the main factor related to patient survival. Classifications, however, fail to correlate treatment with prognosis and cannot suggest the ideal treatment for each tumor stage. The Barcelona Classification (BCLC) attempts to correlate tumor stage with treatment but requires prospective studies for validation. For single tumors smaller than 5 cm or up to three nodules smaller than 3 cm, surgical resection, liver transplantation and percutaneous treatment may offer good anti-tumoral results, as well as improved patient survival. Embolization or chemoembolization are therapeutic alternatives for patients who do not benefit from curative therapies. Correspondence

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