Hand-assisted laparoscopic hepatectomy for primary clear cell hepatocellular carcinoma of the liver

Abstract

We report a case of primary clear cell hepatocellular carcinoma of the liver (PCCCL) for which we performed hand-assisted laparoscopic hepatectomy. A 71-year-old female with hepatitis C infection and diabetes mellitus was admitted to our department for a hepatic tumor with gallstone. Abdominal computed tomography revealed a tumor 25 mm in diameter on the surface in segment 5 of the liver. The imaging results suggested small hepatocellular carcinoma located on the surface in segment 5 of the liver, and we performed laparoscopic surgery aiming at a minimally invasive procedure. We performed laparoscopic cholecystectomy and hand-assisted laparoscopic hepatectomy. Histopathological findings showed moderately differentiated hepatocellular carcinoma, and as the proportion of clear cells was 75%, the tumor was diagnosed as PCCCL. This is the first report of hand-assisted laparoscopic hepatectomy for PCCCL. Laparoscopic hepatectomy is a useful minimally invasive surgical procedure when the tumor is located on the surface of the liver.

Keywords: Hand-assisted laparoscopic hepatectomy; Hepatocellular carcinoma; Primary clear cell hepatocellular carcinoma.

Fig. 1

Abdominal contrast-enhanced computed tomography showed a tumor 25 mm in diameter on the surface in segment 5 of the liver (arrow).

Fig. 2

Angiography showed the lesion on early-phase imaging (a), and tumor was stained on late-phase imaging (b).

Fig. 3

Histopathological findings showed moderately differentiated HCC, and the proportion of clear cells was 75%; however, pseudocapsule formation was not shown in the tumor. HE, ×100.