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KMID : 1103920110170020106
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Korean Journal of Hepatology
2011 Volume.17 No. 2 p.106 ~ p.112
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Treatment and clinical outcome of needle-track seeding from hepatocellular carcinoma
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Ahn Dong-Won
Shim Ju-Hyun
Yoon Jung-Hwan
Kim Chung-Yong
Lee Hyo-Suk
Kim Yeong-Tae
Kim Yoon-Jun
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Abstract
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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.
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KEYWORD
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Carcinoma, Hepatocellular, Ultrasonography, Interventional, Neoplasm seeding
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