Novel treatment strategy with radiofrequency ablation and surgery for pregnant patients with hepatocellular carcinoma: a case report

Abstract Background Hepatocellular carcinoma (HCC) during pregnancy is rare, with a poor prognosis. Recently, however, increasing resection rates have improved survival rate. Currently, various surgeries are safely performed after the second trimester and termination of pregnancy is not always neces...

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Main Authors: Megumi Matsuo, Katsunori Furukawa, Hiroaki Shimizu, Hideyuki Yoshitomi, Tsukasa Takayashiki, Satoshi Kuboki, Shigetsugu Takano, Daisuke Suzuki, Nozomu Sakai, Shingo Kagawa, Hiroyuki Nojima, Masayuki Ohsuka
Format: Article
Language:English
Published: Japan Surgical Society 2018-05-01
Series:Surgical Case Reports
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Online Access:http://link.springer.com/article/10.1186/s40792-018-0434-3
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author Megumi Matsuo
Katsunori Furukawa
Hiroaki Shimizu
Hideyuki Yoshitomi
Tsukasa Takayashiki
Satoshi Kuboki
Shigetsugu Takano
Daisuke Suzuki
Nozomu Sakai
Shingo Kagawa
Hiroyuki Nojima
Masayuki Ohsuka
author_facet Megumi Matsuo
Katsunori Furukawa
Hiroaki Shimizu
Hideyuki Yoshitomi
Tsukasa Takayashiki
Satoshi Kuboki
Shigetsugu Takano
Daisuke Suzuki
Nozomu Sakai
Shingo Kagawa
Hiroyuki Nojima
Masayuki Ohsuka
author_sort Megumi Matsuo
collection DOAJ
description Abstract Background Hepatocellular carcinoma (HCC) during pregnancy is rare, with a poor prognosis. Recently, however, increasing resection rates have improved survival rate. Currently, various surgeries are safely performed after the second trimester and termination of pregnancy is not always necessary. However, surgery is sometimes limited by gestational age or the patient’s will. When patients with HCC refuse surgery during pregnancy, we face specific problems with respect to curability and fetal life. Meanwhile, previous studies have revealed radiofrequency ablation (RFA) as a possible alternative to surgery for the treatment of early HCC and shown its favorable local control rate for advanced HCC. However, no case of HCC treated with RFA during pregnancy has yet been reported. Case presentation Here, we present the case of a 33-year-old woman, who was a hepatitis B virus carrier. The patient had been followed up because HBV carrier could develop hepatitis or HCC. And she was diagnosed with a 40-mm HCC tumor at 17 weeks of gestation. She refused surgery because she was pregnant and wanted to continue her pregnancy; therefore, we performed RFA for the local control of her HCC at 17 weeks of gestation and radical surgery at postpartum. She delivered a healthy baby and has survived without recurrence for 6 years after the surgery. Conclusions Surgery is potentially a curative treatment for HCC whether the patient is pregnant or not. However, various problems unique to pregnancy make it difficult to perform a straightforward surgery. Our case revealed that RFA can be safely performed in pregnant patients during the second trimester, and the combination of RFA and surgery can radically increase the resection rate of HCC during pregnancy.
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spelling doaj-art-cd317e41262040af8ea2cf7555ddcfae2025-08-20T03:39:14ZengJapan Surgical SocietySurgical Case Reports2198-77932018-05-01411510.1186/s40792-018-0434-3Novel treatment strategy with radiofrequency ablation and surgery for pregnant patients with hepatocellular carcinoma: a case reportMegumi Matsuo0Katsunori Furukawa1Hiroaki Shimizu2Hideyuki Yoshitomi3Tsukasa Takayashiki4Satoshi Kuboki5Shigetsugu Takano6Daisuke Suzuki7Nozomu Sakai8Shingo Kagawa9Hiroyuki Nojima10Masayuki Ohsuka11The Department of General surgery, Graduate School of Medicine, Chiba UniversityThe Department of General surgery, Graduate School of Medicine, Chiba UniversityThe Department of General surgery, Graduate School of Medicine, Chiba UniversityThe Department of General surgery, Graduate School of Medicine, Chiba UniversityThe Department of General surgery, Graduate School of Medicine, Chiba UniversityThe Department of General surgery, Graduate School of Medicine, Chiba UniversityThe Department of General surgery, Graduate School of Medicine, Chiba UniversityThe Department of General surgery, Graduate School of Medicine, Chiba UniversityThe Department of General surgery, Graduate School of Medicine, Chiba UniversityThe Department of General surgery, Graduate School of Medicine, Chiba UniversityThe Department of General surgery, Graduate School of Medicine, Chiba UniversityThe Department of General surgery, Graduate School of Medicine, Chiba UniversityAbstract Background Hepatocellular carcinoma (HCC) during pregnancy is rare, with a poor prognosis. Recently, however, increasing resection rates have improved survival rate. Currently, various surgeries are safely performed after the second trimester and termination of pregnancy is not always necessary. However, surgery is sometimes limited by gestational age or the patient’s will. When patients with HCC refuse surgery during pregnancy, we face specific problems with respect to curability and fetal life. Meanwhile, previous studies have revealed radiofrequency ablation (RFA) as a possible alternative to surgery for the treatment of early HCC and shown its favorable local control rate for advanced HCC. However, no case of HCC treated with RFA during pregnancy has yet been reported. Case presentation Here, we present the case of a 33-year-old woman, who was a hepatitis B virus carrier. The patient had been followed up because HBV carrier could develop hepatitis or HCC. And she was diagnosed with a 40-mm HCC tumor at 17 weeks of gestation. She refused surgery because she was pregnant and wanted to continue her pregnancy; therefore, we performed RFA for the local control of her HCC at 17 weeks of gestation and radical surgery at postpartum. She delivered a healthy baby and has survived without recurrence for 6 years after the surgery. Conclusions Surgery is potentially a curative treatment for HCC whether the patient is pregnant or not. However, various problems unique to pregnancy make it difficult to perform a straightforward surgery. Our case revealed that RFA can be safely performed in pregnant patients during the second trimester, and the combination of RFA and surgery can radically increase the resection rate of HCC during pregnancy.http://link.springer.com/article/10.1186/s40792-018-0434-3Hepatocellular carcinomaPregnancyRadiofrequency ablation
spellingShingle Megumi Matsuo
Katsunori Furukawa
Hiroaki Shimizu
Hideyuki Yoshitomi
Tsukasa Takayashiki
Satoshi Kuboki
Shigetsugu Takano
Daisuke Suzuki
Nozomu Sakai
Shingo Kagawa
Hiroyuki Nojima
Masayuki Ohsuka
Novel treatment strategy with radiofrequency ablation and surgery for pregnant patients with hepatocellular carcinoma: a case report
Surgical Case Reports
Hepatocellular carcinoma
Pregnancy
Radiofrequency ablation
title Novel treatment strategy with radiofrequency ablation and surgery for pregnant patients with hepatocellular carcinoma: a case report
title_full Novel treatment strategy with radiofrequency ablation and surgery for pregnant patients with hepatocellular carcinoma: a case report
title_fullStr Novel treatment strategy with radiofrequency ablation and surgery for pregnant patients with hepatocellular carcinoma: a case report
title_full_unstemmed Novel treatment strategy with radiofrequency ablation and surgery for pregnant patients with hepatocellular carcinoma: a case report
title_short Novel treatment strategy with radiofrequency ablation and surgery for pregnant patients with hepatocellular carcinoma: a case report
title_sort novel treatment strategy with radiofrequency ablation and surgery for pregnant patients with hepatocellular carcinoma a case report
topic Hepatocellular carcinoma
Pregnancy
Radiofrequency ablation
url http://link.springer.com/article/10.1186/s40792-018-0434-3
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