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Korean J Hepatol > Volume 12(3); 2006 > Article
The Korean Journal of Hepatology 2006;12(3): 412-419.
Surgical Treatment of Sclerosing Hepatocellular Carcinoma
Bum-Soo Kim, M.D., Sung-Gyu Lee, M.D., Shin Hwang, M.D., Young-Joo Lee, M.D., Kwang-Min Park, M.D., Ki-Hun Kim, M.D., Chul-Soo Ahn, M.D., Deok-Bog Moon, M.D., Tae-Yong Ha, M.D., Gi-Won Song, M.D., Dong-Hwan Jung, M.D., and Ki-Myung Moon, M.D.
Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

Sclerosing hepatocellular carcinoma (HCC) is an unusual subtype of HCC that is characterized by an embedded dense fibrous stroma in the tubular neoplastic structures. We aimed to assess the surgical approaches and outcomes of sclerosing HCC.
We retrospectively analyzed the clinicopathologic features of 6 patients with sclerosing HCC who underwent surgical treatment at Asan Medical Center between July 1989 and December 2005.
Six HCC patients with sclerosing HCC were diagnosed out of the total 1390 HCC patients (0.43%) during the study period. The mean age was 58 years and 4 patients were male. Weight loss and abdominal pain were the most common symptoms. The serum calcium and phosphorus levels were normal in all the patients. All of them were hepatitis B surface antigen-positive, but none was positive for hepatitis C. All the lesions were solitary. The tumor size ranged from 45 to 150 mm in diameter (median size: 81 mm). We performed right trisegmentectomy (n=1), central bisegmentectomy (n=1), right anterior segmentectomy (n=1), ex-vivo resection and autotransplantation (n=1) and right posterior segmentectomy (n=2). The median overall survival and disease free-survival periods were 24 months and 9.5 months, respectively.
The incidence of sclerosing HCC was very low. Sclerosing HCC was often not correctly diagnosed before an operation, but performing resection prolonged the patients’ survival and their prognosis was not worse than that for ordinary HCC. Our experience implicates that aggressive surgical treatment for sclerosing HCC is beneficial for patient survival. (Korean J Hepatol 2006;12:412-419)
KeyWords: Sclerosing hepatocellular carcinoma; Incidence; Diagnosis; Therapeutics; Treatment outcome
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