Multimodal Treatment of a Case of Synchronous Recurrent Hepatocarcinoma and Retroperitoneal Liposarcoma

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, Italy

^*Correspondance to: Francesca Cardella 

 PDF  Full Text DOI: 10.25107/2474-1647.2313

Abstract

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.

Keywords

Hepatocellular carcinoma; Retroperitoneal liposarcoma; Multimodal treatment; Radiofrequency Ablation; Contrast-Enhanced ultrasound

Cite the article

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.