Long-term survival of 11 years with multidisciplinary therapy for hepatocellular carcinoma metastasis to the ovary and peritoneum: a case report

Abstract

We herein report a rare case of HCC metastases to the ovary and peritoneum in a 61-year-old female patient who has achieved 11-year survival with multidisciplinary therapy. The patient was diagnosed with HCC during balloon angioplasty performed for Budd–Chiari syndrome in 1994 and underwent partial hepatectomy twice. Five years after the second hepatectomy, allochronic recurrence of a single nodule detected in S8 was treated by radiofrequency ablation, followed by percutaneous ethanol injection therapy and stereotactic body radiotherapy. However, her α-fetoprotein level rose to 1862 ng/mL within one year and computed tomography revealed a large pelvic tumor suggesting HCC metastasis to the ovary. The subsequent laparotomy revealed one 11-cm left ovarian tumor, one small right ovarian nodule, and numerous peritoneal nodules. Bilateral salpingo-oophorectomy and peritoneal resection of as many nodules as possible were performed. Combination therapy with intravenous 5-fluorouracil plus cisplatin and ramucirumab monotherapy effectively suppressed tumor progression with maintenance of hepatic functional reserve, and she has achieved long-term survival of 11 years, illustrating that multidisciplinary therapy with favorable hepatic functional reserve maintenance can contribute to long-term survival in HCC with extrahepatic spread.

A Rare Case of Hepatocellular Carcinoma Recurrence in Ovarian Site after 12 Years Mimicking a Hepatoid Adenocarcinoma: Case Report

“…Hepatocarcinoma usually spreads by the hematogenous or lymphatic route, or by direct invasion of adjacent organs. Common sites of metastasis are lungs, peritoneum, bones, and adrenal glands [ 14 ]. The ovary is a rare site of metastasis for hepatocellular carcinoma, with less than 20 cases reported in the literature up to now [ 12 , 15 ].…”

Case report: Olaparib as an experimental therapy in a BRCA2-mutated patient with metastatic ovarian adenocarcinoma that originated from liver cancer

“…The common primary tumors that give rise to ovarian metastases include breast, colorectal, endometrial, stomach, and appendix cancer ( 1 ). Liver cancer is one of the exceedingly rare malignancies that metastasize to the ovary, with only 17 cases reported in the literature, which was first reported in 1983 ( 2 ). The prognosis of patients with ovarian metastasis is generally poor, with a 5-year survival rate of 18.5%.…”

“…one of the exceedingly rare malignancies that metastasize to the ovary, with only 17 cases reported in the literature, which was first reported in 1983 (2). The prognosis of patients with ovarian metastasis is generally poor, with a 5-year survival rate of 18.5%.…”

Metastatic Hepatocellular Carcinoma Represents an Important but Rare Pitfall in the Diagnostic Evaluation of ER Negative Ovarian Malignancy: A Case Report

“…Metastatic hepatocellular carcinoma (HCC) to the ovary is a rare event 1–6 and a challenging diagnosis in the absence of relevant clinical history. The differential diagnosis includes a primary surface ovarian carcinoma with hepatoid differentiation, yolk sac tumor (YST) with hepatoid differentiation, metastatic hepatoid carcinoma from other organs, and primary hepatoid carcinoma of the ovary 6–9 .…”