Ex vivo hepatectomy and partial liver autotransplantation for hepatoid adenocarcinoma: A case report

Abstract

Abstract.We previously reported the case of a 56-year-old male who underwent surgical treatment for gastric hepatoid adenocarcinoma and splenic metastasis. The present study reports the case of the same patient who underwent successful ex vivo hepatectomy and partial liver autotransplantation. Computed tomography scans demonstrated that the tumor was located in the left and caudate lobes of the liver, with hepatic vein and inferior vena cava involvement, and right portal vein compression. To clarify the association between the vessels and the tumor, a three-dimensional imaging technique was used to reconstruct the liver architecture. During the surgery, the whole liver was removed with the retrohepatic vena cava, which was replaced with a prosthetic graft without a veno-venous bypass; a portacaval shunt for the anhepatic phase was performed simultaneously. The surgery lasted 9 h, and the anhepatic phase lasted 4 h. Blood loss during the surgery was recorded at 1,500 ml. The time taken for recovery was 21 days post-surgery, and at 20 months, the patient was disease-free. To the best of our knowledge, this is the first case of ex vivo liver resection performed for hepatic metastasis of hepatoid adenocarcinoma to be reported.

Hepatoid Adenocarcinoma of the Stomach: Current Perspectives and New Developments

“…Radical surgery in combination with adjuvant chemotherapy is regarded as the optimal treatment approach (2). Gastric and liver metastasis resection is occasionally performed for palliation in advanced/ metastatic HAS patients (85). And it was suggested that salvage surgery following chemotherapy could achieve curative resection of HAS with portal vein tumor thrombus (PVTT) (70).…”

Ex vivo liver resection and autotransplantation with cardiopulmonary bypass for hepatoblastoma in children: A case report

“…The liver can safely tolerate total vascular occlusion for only approximately 60-90 minutes under normal temperature via conventional Pringle hepatic inflow occlusion 9. The blocking time is short but may cause residual liver ischemia, hepatic vein and inferior vena cava bleeding, multiple organ failure, and other complications 10,11. Liver transplantation was performed in this patient with total hepatic vascular occlusion at low temperature.…”

<p>Therapeutic Approaches to Gastric Hepatoid Adenocarcinoma: Current Perspectives</p>

“…Anecdotally, Wang et al41 recently described a 56-year-old male with progressive therapy-resistant metachronous liver metastases, as judged by increased biomarker levels (CEA and AFP), despite transcatheter arterial chemoembolization (TACE) and radiofrequency ablation. Sorafenib had to be stopped due to early adverse reactions.…”

“…Sorafenib had to be stopped due to early adverse reactions. The patient underwent ex vivo hepatectomy and a partial liver autotransplantation, and 20 months after the liver autotransplantation, he was reported to be relapse-free and still alive 41…”