Right extended hepatectomy with vascular and biliary reconstruction for fibrolamelar hcc with portal vein thrombosis and biliary infiltration. Case report

Abstract

The fibrolamellar hepatocellular carcinoma it is a rare liver tumor, who growth in normal liver parenquima, in absent of viral hepatitis, metabolic liver disorders or any inflammatory condition, the long term survival can reach up to 70% in 5 years. Clinic case: A 14 years old male, with ictericia, abdominal growth circumference, the US and Abdominal CT revealed: 16cm liver tumor in segments 1,5,6,7, with tumoral thrombus in right portal vein and main trunk, and intrahepatic biliary dilatation. Surgical treatment: Extended right hepatectomy to segment 1, with vascular and biliary reconstruction (resection and anastomosis of portal vein). Operative time: 390 minutes, blood looses 1800 ml, ICU 7 days, total hospital stay 21 days, Clavien III-A complications (abdominal abscess and pleural effusion). Pathological results: Fibrolamellar hepatocellular carcinoma, free margin. Adjuvant therapy  based on gemcitabine and oxaloplatin (6 cylcles), actually he is 16 months of follow up, disease free and with a normal life.