Annamaria Auricchio, Francesca Cardella*, Nicoletta Basile, Silvia Erario, Giovanni Del Sorbo, Paolo Castellano, Gennaro Galizia, Eva Lieto and Andrea Mabilia
Department of Translational Medical Sciences, University of Campania 'Luigi Vanvitelli' - School of Medicine, ItalyFulltext PDF
Background: The treatment of simultaneous oncological diseases in patients with other severe comorbidities may be challenging. Multimodality treatment including percutaneous ablation and surgical resection may represent a valid option.Case
Presentation: We report a singular case of a 71-year-old woman with diabetes, hypertensive heart disease, and HCV-related liver cirrhosis showing synchronous retroperitoneal liposarcoma and recurrent hepatocarcinoma. The patients have been treated, two years and one year before, with ablative therapy for hepatocarcinomas grown in the IV-V and IV-VIII hepatic segments, respectively. On November 2015, the patient was admitted at our Department for a large retroperitoneal liposarcoma in the left abdomen and preoperative imaging discovered a recurrent HCC at the site of the previous ablation. In order to offer a chance of cure to the patient, a multimodal approach was performed. It made up of two surgical phases, a thermoablative phase followed by a resective phase, with a combined surgical treatment: ultrasound-guided percutaneous radiofrequency ablation of recurrent hepatocarcinoma at the IV-VIII hepatic segments and removal of the retroperitoneal mass. By adopting this kind of strategy two main goals were achieved: treating two neoplastic lesions in two different organs at the same time, thus preserving the patient from multiple general anesthesia procedures.Conclusion: Ablation is nearly 100% effective in hepatocellular carcinomas smaller than 2 cm, and survival is almost identical after resection or ablation. On the other hand, the complete resection of a retroperitoneal sarcoma remains the most important predictor of local recurrence and overall survival. Both procedures can be performed simultaneously.
Hepatocellular carcinoma; Retroperitoneal liposarcoma; Multimodal treatment; Radiofrequency Ablation; Contrast-Enhanced ultrasound
Auricchio A, Cardella F, Basile N, Erario S, Del Sorbo G, Castellano P, et al. Multimodal Treatment of a Case of Synchronous Recurrent Hepatocarcinoma and Retroperitoneal Liposarcoma. Clin Surg. 2019; 4: 2313.