Undifferentiated Embryonal Sarcoma of the Liver Involving All Major Hepatic Veins Treated by Left Extended Trisectionectomy
Introduction. Over the past few years, liver surgery has been in constant evolution and gained many improvements that helped surgeons push limits further. A complex procedure such as left extended trisectionectomy, as described by Makuuchi in 1987, may be performed in selected cases. Aim. Describe a...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-01-01
|
| Series: | Case Reports in Surgery |
| Online Access: | http://dx.doi.org/10.1155/2022/9673901 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832565784413470720 |
|---|---|
| author | Reinaldo Fernandes Klaus Steinbrück Jan-Peter Périssé Rodrigo Luz Renato Cano Fernanda Cruz-Nunes Diego Garcia Rodrigo Diaz Fernanda Cavalcanti Carneiro Andrea Velloso Carlos Frederico Campos Marcelo Enne |
| author_facet | Reinaldo Fernandes Klaus Steinbrück Jan-Peter Périssé Rodrigo Luz Renato Cano Fernanda Cruz-Nunes Diego Garcia Rodrigo Diaz Fernanda Cavalcanti Carneiro Andrea Velloso Carlos Frederico Campos Marcelo Enne |
| author_sort | Reinaldo Fernandes |
| collection | DOAJ |
| description | Introduction. Over the past few years, liver surgery has been in constant evolution and gained many improvements that helped surgeons push limits further. A complex procedure such as left extended trisectionectomy, as described by Makuuchi in 1987, may be performed in selected cases. Aim. Describe a case of successful resection of a huge bilobar liver sarcoma involving all hepatic veins from a young female patient, in which the blood outflow was preserved through an inferior right hepatic vein, leaving only segment 6 as liver remnant. Case Report. A 19-year-old female with a 3-month history of abdominal pain, vomiting, and weight loss was referred for our evaluation. CT scan and MRI revealed a heterogeneous and bulky expansive hepatic lesion, sparing only segment 6, with an estimated volume of 530 cm3, corresponding to a 1.2 FLR/BW ratio. The tumor involved the three major hepatic veins, but an inferior right hepatic vein was present, draining the spared segment 6. She was submitted to a left trisectionectomy extended to the caudate lobe and segment 7, including resection of all hepatic veins and lymphadenectomy of the hepatic pedicle. She was discharged on the 7th postoperative day without complications. The histopathological and immunohistochemical analysis demonstrated an undifferentiated embryonal sarcoma of the liver. Conclusion. Inferior right hepatic vein-preserving left extended trisectionectomy is a safe and feasible procedure that should be performed by a hepatobiliary team experienced in major complex hepatectomies. |
| format | Article |
| id | doaj-art-674513c5f260401197734972ef99e89b |
| institution | Kabale University |
| issn | 2090-6919 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Surgery |
| spelling | doaj-art-674513c5f260401197734972ef99e89b2025-02-03T01:06:36ZengWileyCase Reports in Surgery2090-69192022-01-01202210.1155/2022/9673901Undifferentiated Embryonal Sarcoma of the Liver Involving All Major Hepatic Veins Treated by Left Extended TrisectionectomyReinaldo Fernandes0Klaus Steinbrück1Jan-Peter Périssé2Rodrigo Luz3Renato Cano4Fernanda Cruz-Nunes5Diego Garcia6Rodrigo Diaz7Fernanda Cavalcanti Carneiro8Andrea Velloso9Carlos Frederico Campos10Marcelo Enne11Equipe Multidisciplinar Hepatobiliar – EMHepEquipe Multidisciplinar Hepatobiliar – EMHepMedical SchoolEquipe Multidisciplinar Hepatobiliar – EMHepEquipe Multidisciplinar Hepatobiliar – EMHepEquipe Multidisciplinar Hepatobiliar – EMHepEquipe Multidisciplinar Hepatobiliar – EMHepEquipe Multidisciplinar Hepatobiliar – EMHepAnesthesiology DepartmentBrazilian Hepatology SocietyPathology DepartmentEquipe Multidisciplinar Hepatobiliar – EMHepIntroduction. Over the past few years, liver surgery has been in constant evolution and gained many improvements that helped surgeons push limits further. A complex procedure such as left extended trisectionectomy, as described by Makuuchi in 1987, may be performed in selected cases. Aim. Describe a case of successful resection of a huge bilobar liver sarcoma involving all hepatic veins from a young female patient, in which the blood outflow was preserved through an inferior right hepatic vein, leaving only segment 6 as liver remnant. Case Report. A 19-year-old female with a 3-month history of abdominal pain, vomiting, and weight loss was referred for our evaluation. CT scan and MRI revealed a heterogeneous and bulky expansive hepatic lesion, sparing only segment 6, with an estimated volume of 530 cm3, corresponding to a 1.2 FLR/BW ratio. The tumor involved the three major hepatic veins, but an inferior right hepatic vein was present, draining the spared segment 6. She was submitted to a left trisectionectomy extended to the caudate lobe and segment 7, including resection of all hepatic veins and lymphadenectomy of the hepatic pedicle. She was discharged on the 7th postoperative day without complications. The histopathological and immunohistochemical analysis demonstrated an undifferentiated embryonal sarcoma of the liver. Conclusion. Inferior right hepatic vein-preserving left extended trisectionectomy is a safe and feasible procedure that should be performed by a hepatobiliary team experienced in major complex hepatectomies.http://dx.doi.org/10.1155/2022/9673901 |
| spellingShingle | Reinaldo Fernandes Klaus Steinbrück Jan-Peter Périssé Rodrigo Luz Renato Cano Fernanda Cruz-Nunes Diego Garcia Rodrigo Diaz Fernanda Cavalcanti Carneiro Andrea Velloso Carlos Frederico Campos Marcelo Enne Undifferentiated Embryonal Sarcoma of the Liver Involving All Major Hepatic Veins Treated by Left Extended Trisectionectomy Case Reports in Surgery |
| title | Undifferentiated Embryonal Sarcoma of the Liver Involving All Major Hepatic Veins Treated by Left Extended Trisectionectomy |
| title_full | Undifferentiated Embryonal Sarcoma of the Liver Involving All Major Hepatic Veins Treated by Left Extended Trisectionectomy |
| title_fullStr | Undifferentiated Embryonal Sarcoma of the Liver Involving All Major Hepatic Veins Treated by Left Extended Trisectionectomy |
| title_full_unstemmed | Undifferentiated Embryonal Sarcoma of the Liver Involving All Major Hepatic Veins Treated by Left Extended Trisectionectomy |
| title_short | Undifferentiated Embryonal Sarcoma of the Liver Involving All Major Hepatic Veins Treated by Left Extended Trisectionectomy |
| title_sort | undifferentiated embryonal sarcoma of the liver involving all major hepatic veins treated by left extended trisectionectomy |
| url | http://dx.doi.org/10.1155/2022/9673901 |
| work_keys_str_mv | AT reinaldofernandes undifferentiatedembryonalsarcomaoftheliverinvolvingallmajorhepaticveinstreatedbyleftextendedtrisectionectomy AT klaussteinbruck undifferentiatedembryonalsarcomaoftheliverinvolvingallmajorhepaticveinstreatedbyleftextendedtrisectionectomy AT janpeterperisse undifferentiatedembryonalsarcomaoftheliverinvolvingallmajorhepaticveinstreatedbyleftextendedtrisectionectomy AT rodrigoluz undifferentiatedembryonalsarcomaoftheliverinvolvingallmajorhepaticveinstreatedbyleftextendedtrisectionectomy AT renatocano undifferentiatedembryonalsarcomaoftheliverinvolvingallmajorhepaticveinstreatedbyleftextendedtrisectionectomy AT fernandacruznunes undifferentiatedembryonalsarcomaoftheliverinvolvingallmajorhepaticveinstreatedbyleftextendedtrisectionectomy AT diegogarcia undifferentiatedembryonalsarcomaoftheliverinvolvingallmajorhepaticveinstreatedbyleftextendedtrisectionectomy AT rodrigodiaz undifferentiatedembryonalsarcomaoftheliverinvolvingallmajorhepaticveinstreatedbyleftextendedtrisectionectomy AT fernandacavalcanticarneiro undifferentiatedembryonalsarcomaoftheliverinvolvingallmajorhepaticveinstreatedbyleftextendedtrisectionectomy AT andreavelloso undifferentiatedembryonalsarcomaoftheliverinvolvingallmajorhepaticveinstreatedbyleftextendedtrisectionectomy AT carlosfredericocampos undifferentiatedembryonalsarcomaoftheliverinvolvingallmajorhepaticveinstreatedbyleftextendedtrisectionectomy AT marceloenne undifferentiatedembryonalsarcomaoftheliverinvolvingallmajorhepaticveinstreatedbyleftextendedtrisectionectomy |