Treatment and clinical outcome of needle-track seeding from hepatocellular carcinoma.
10.3350/kjhep.2011.17.2.106
- Author:
Dong Won AHN
1
;
Ju Hyun SHIM
;
Jung Hwan YOON
;
Chung Yong KIM
;
Hyo Suk LEE
;
Yeong Tae KIM
;
Yoon Jun KIM
Author Information
1. Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Carcinoma, Hepatocellular;
Ultrasonography, Interventional;
Neoplasm seeding
- MeSH:
Adult;
Biopsy, Fine-Needle/*adverse effects;
Carcinoma, Hepatocellular/*secondary/therapy/ultrasonography;
Female;
Humans;
Liver Neoplasms/*pathology/therapy/ultrasonography;
Male;
Middle Aged;
*Neoplasm Seeding;
Retrospective Studies;
Skin Neoplasms/secondary;
Tomography, X-Ray Computed
- From:The Korean Journal of Hepatology
2011;17(2):106-112
- CountryRepublic of Korea
- Language:English
-
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 needle-tracks 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.
