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ORIGINAL ARTICLES  
CMH 2011 June;17:106-112.
Published online 2011 March 22. doi:http://dx.doi.org/10.3350/kjhep.2011.17.2.106
Copyright © 2011 The Korean Association for the Study of the Liver
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Treatment and clinical outcome of needle-track seeding from hepatocellular carcinoma
Dong-Won Ahn1, Ju Hyun Shim2, Jung-Hwan Yoon3, Chung Yong Kim3, Hyo-Suk Lee3, Yeong Tae Kim4, and Yoon Jun Kim3
1Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
2Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
3Department of Internal Medicine and Liver Research Institute
4Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
Corresponding Author: Yoon Jun Kim ,Tel: +82-2-2072-3081, Fax: +82-2-762-9662, Email: yoonjun@snu.ac.kr
ABSTRACT
Background/Aims: Needle-track seeding is a rare but important complication of diagnostic and therapeutic ultrasound (US)-guided procedures in hepatocellular carcinoma (HCC). We examined the frequency of needle-track seeding after US-guided percutaneous ethanol injection (PEI), fine-needle aspiration biopsy (FNAB), and percutaneous transhepatic biliary drainage (PTBD) in order to determine the appropriate treatment for needle-track seeding and its clinical outcome. Methods: We analyzed the clinical characteristics and treatment outcomes in eight patients who experienced needle-track seeding from HCC after an US-guided procedure (FNAB, PEI, or PTBD) between January 1990 and July 2004. Results: Seven (0.14%) of 5,092 patients who experienced needle-track seeding (2 after PEI, 4 after FNAB, and 1 after PTBD) during the study period and 1 other patient who experienced needle-track seeding recently were recruited for this study. Two of the eight patients underwent mass excision and the other six patients underwent en-bloc wide excision for the needle-track seeding. Tumors recurred in the needletracks in both patients who underwent mass excision but not in the six patients who underwent en-bloc wide excision. Mortality occurred in three patients who experienced the recurrence and progression of intrahepatic HCC. Conclusions: The incidence of needle-track seeding after US-guided procedures in HCC was 0.14%. En-bloc wide excision seems to be the optimal treatment for minimizing the probability of tumor recurrence due to needle-track seeding.
Keywords: Carcinoma, Hepatocellular; Ultrasonography, Interventional; Neoplasm seeding
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