A case of subcutaneous seeding of hepatocellular carcinoma after fine needle aspiration biopsy

Abstract

Cancer spread along the needle track following fine needle aspiration biopsy is said to be a rare complication. The authors report a case of subcutaneous implantation of hepatocellular carcinoma following ultrasono-guided fine needle aspiration biopsy. The patient, a 67-year-old Korean male was found to have a large hepatocellular carcinoma diagnosed by fine needle aspiration biopsy. Four months later, the patient felt two subcutaneous growing lumps at the previous aspiration site. The authors confirmed them histologically 11 months after aspiration.

Fig. 1.

Abdominal CT scan showed an inhomogeneously enhanced hepatic tumor with well demarcation. (9 × 9 × 8 cm).

Fig. 2a.

Chronic persistent hepatitis showing chronic inflammatory cell infiltration and widening of the portal tract.

Fig. 2b.

Hepatocellular carcinoma showing trabecular pattern with sinusoidal structure and pleomorphic epithelial cells resembling hepatocytes.

Fig. 3.

The subcutaneous lumps were noted at the previous ultrasonoguided needle biopsy site.

Fig. 4.

Abdominal CT scan showed a more enlarged size (10 × 10 × 11 cm) with evidence of metastasis to the abdominal wall and only a small amount of lipiodol droplets remaining in the tumor.

Fig. 5.

Irregular sheet of malignant epithelial cells which have anisonucleosis. hyperchromatism and occasional distinct nucleoli.