Splenectomy Followed by Hepatectomy for Hepatocellular Carcinoma with Hypersplenism and Portal Hypertension Caused by Macroglobulinemia.

Abstract

AIM:

To describe a patient with hepatocellular carcinoma (HCC), accompanied by hypersplenism and portal hypertension caused by macroglobulinemia, who underwent splenectomy followed by hepatectomy.

CASE REPORT:

A 74-year-old man was admitted to our Hospital. He had previously developed primary macroglobulinemia, which had been completely cured by chemotherapy. At admission, he had a low platelet count (52 × 10(3)/μl), and his liver function was impaired. Imaging showed a 5-cm-sized tumor, an esophageal varix, and splenomegaly, but not liver cirrhosis. The patient underwent splenectomy for hypersplenism and portal hypertension; the weight of his spleen was 2,400 g. After splenectomy, his platelet count increased to 259 × 10(3)/μl and his liver function was improved. He safely underwent hepatectomy for HCC. The patient was discharged 14 days later without morbidity.

CONCLUSION:

These findings suggest that hepatectomy following splenectomy for hypersplenism and portal hypertension caused by macroglobulinemia, may effectively cure HCC in patients with liver dysfunction and thrombocytopenia.

• Authors: Qingjiang Hu, Kazuki Takeishi, Yo-Ichi Yamashita, Tetsuo Ikeda, Huanlin Wang, Shinji Itoh, Norifumi Harimoto, Toru Ikegami, Tomoharu Yoshizumi, Hirofumi Kawanaka, Ken Shirabe, Yoshihiko Maehara
• Journal: Anticancer research (Anticancer Res) Vol. 35 Issue 7 Pg. 4077-81 (Jul 2015) ISSN: 1791-7530 [Electronic] Greece
• PMID: 26124358 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Topics

• Aged
• Carcinoma, Hepatocellular (surgery)
• Hepatectomy (methods)
• Humans
• Hypersplenism (surgery)
• Hypertension, Portal (surgery)
• Liver Neoplasms (surgery)
• Male
• Splenectomy (methods)
• Waldenstrom Macroglobulinemia (surgery)