Journal of the Chinese Medical Association
Volume 71, Issue 1 , Pages 40-44, January 2008

Successful Radiofrequency Ablation Therapy for Hepatocellular Carcinoma in a Male Patient with Early Stage Primary Biliary Cirrhosis and Positive Serum Hepatitis B Core Antibody

  • Chien-Wei Su

      Affiliations

    • Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital; Taipei, Taiwan, R.O.C.
    • Institutes of Clinical Medicine and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Jaw-Ching Wu

      Affiliations

    • Departments of Medical Research and Education, Taipei Veterans General Hospital; Taipei, Taiwan, R.O.C.
    • Institutes of Clinical Medicine and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Jaw-Ching Wu, Institute of Clinical Medicine, National Yang-Ming University School of Medicine, 155, Section 2, Li-Nong Street, Taipei 112, Taiwan, R.O.C
    • ,
  • Yi-You Chiou

      Affiliations

    • Departments of Radiology, Taipei Veterans General Hospital; Taipei, Taiwan, R.O.C.
    • ,
  • Shyh-Haw Tsay

      Affiliations

    • Departments of Pathology and Laboratory Medicine, Taipei Veterans General Hospital; Taipei, Taiwan, R.O.C.
    • ,
  • Teh-Ia Huo

      Affiliations

    • Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital; Taipei, Taiwan, R.O.C.
    • Institutes of Pharmacology and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Yi-Hsiang Huang

      Affiliations

    • Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital; Taipei, Taiwan, R.O.C.
    • Institutes of Clinical Medicine and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Hung-Hsu Hung

      Affiliations

    • Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital; Taipei, Taiwan, R.O.C.
    • ,
  • Han-Chieh Lin

      Affiliations

    • Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital; Taipei, Taiwan, R.O.C.
    • Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Shou-Dong Lee

      Affiliations

    • Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital; Taipei, Taiwan, R.O.C.
    • Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.

Received 28 June 2007; accepted 14 September 2007.

Article Outline

Hepatocellular carcinoma (HCC) occurring in a 66-year-old male patient with early stage primary biliary cirrhosis (PBC) was successfully treated by radiofrequency ablation (RFA) therapy. He was diagnosed with PBC based on the findings of pruritus, elevated serum alkaline phosphate level and positive serum antimitochondrial antibody in 2005. The serologic tests for hepatitis B surface antigen, hepatitis B surface antibody and hepatitis C virus antibody were all negative. But antibody against hepatitis B core antigen was positive. Abdominal ultrasonography and dynamic computed tomography revealed 1 hypervascular tumor, 2.6 cm in diameter, in segment V of the liver in 2007. Liver biopsy showed a moderately differentiated HCC. Non-tumorous liver was compatible with Scheuer's classification of stage II PBC. The tumor was successfully treated by RFA. This case report demonstrates that HCC can arise from precirrhotic PBC and can be successfully treated by RFA. Regular surveillance for HCC is warranted for all patients with PBC, irrespective of stage.

Key Words:  hepatitis B virus , hepatocellular carcinoma , primary biliary cirrhosis , radiofrequency ablation therapy

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Kaplan MM , Gershwin ME . Primary biliary cirrhosis . N Engl J Med . 2005;353:1261–1273
  2. Heathcote J . The clinical expression of primary biliary cirrhosis . Semin Liver Dis . 1997;17:23–33
  3. Prince M , Chetwynd A , Newman W , Metcalf JV , James OFW . Survival and symptom progression in a large cohort of patients with primary biliary cirrhosis: follow-up for up to 28 years . Gastroenterology . 2002;123:1044–1051
  4. Talwalkar JA , Lindor KD . Primary biliary cirrhosis . Lancet . 2003;362:53–61
  5. Pares A , Caballeria L , Rodes J . Excellent long-term survival in patients with primary biliary cirrhosis and biochemical response to ursodeoxycholic acid . Gastroenterology . 2006;130:715–720
  6. Nakanuma Y , Terada T , Doishita K , Miwa A . Hepatocellular carcinoma in primary biliary cirrhosis: an autopsy study . Hepatology . 1990;11:1010–1016
  7. Krasner N , Johnson PJ , Portmann B , Watkinson G , Macsween RNM , Williams R . Hepatocellular carcinoma in primary biliary cirrhosis: report of four cases . Gut . 1979;20:255–258
  8. Jones DEJ , Metcalf JV , Collier JD , Bassendine MF , James OFW . Hepatocellular carcinoma in primary biliary cirrhosis and its impact on outcomes . Hepatology . 1997;26:1138–1142
  9. Turissini SB , Kaplan MM . Hepatocellular carcinoma in primary biliary cirrhosis . Am J Gastroenterol . 1997;92:676–678
  10. Floreani A , Baragiotta A , Baldo V , Menegon T , Farinati F , Naccarato R . Hepatic and extrahepatic malignancies in primary biliary cirrhosis . Hepatology . 1999;29:1425–1428
  11. Caballeria L , Pares A , Castells A , Gines A , Bru C , Rodes J . Hepatocellular carcinoma in primary biliary cirrhosis: similar incidence to that in hepatitis C virus-related cirrhosis . Am J Gastroenterol . 2001;96:1160–1163
  12. Shibuya A, Tanaka K, Miyakawa H, Shibata M, Takatori M, Sekiyama K, et al  Hepatocellular carcinoma and survival in patients with primary biliary cirrhosis . Hepatology . 2002;35:1172–1178
  13. Nakahira A, Kubo S, Yamamoto T, Ogawa M, Sakebe K, Tanake S, et al  Resection of hepatocellular carcinoma arising from primary biliary cirrhosis . J Gastroenterol . 2004;39:302–303
  14. Kadokawa Y, Omagari K, Ohba K, Kitomura S, Ohara H, Takeshima F, et al  Hepatocellular carcinoma in a male patient with early stage (stage I) primary biliary cirrhosis . Intern Med . 2005;44:207–211
  15. Suzuki A , Lymp J , Donlinger J , Mendes F , Angulo P , Lindor K . Clinical predictors for hepatocellular carcinoma in patients with primary biliary cirrhosis . Clin Gastroenterol Hepatol . 2007;5:259–264
  16. Huo TI, Wu JC, Lee PC, Chau GY, Lui WY, Tsay SH, et al  Sero-clearance of hepatitis B surface antigen in chronic carriers does not necessarily imply a good prognosis . Hepatology . 1998;28:231–236
  17. Liu CJ , Kao JH . Hepatitis B virus-related hepatocellular carcinoma: epidemiology and pathogenic role of viral factors . J Chin Med Assoc . 2007;70:141–145
  18. Omata M , Tateishi R , Yoshida H , Shiina S . Treatment of hepatocellular carcinoma by percutaneous tumor ablation methods: ethanol injection therapy and radiofrequency ablation . Gastroenterology . 2004;127:S159–S166
  19. Huo TI , Huang YH , Wu JC . Percutaneous ablation therapy for hepatocellular carcinoma: current practice and future perspectives . J Chin Med Assoc . 2005;68:155–159
  20. Huang GT, Lee PH, Tsang YM, Lai MY, Yang PM, Hu RH, et al  Percutaneous ethanol injection versus surgical resection for the treatment of small hepatocellular carcinoma: a prospective study . Ann Surg . 2005;242:36–42
  21. Chen MS, Li JQ, Zheng Y, Guo RP, Liang HH, Zhang YQ, et al  A prospective randomized trial comparing percutaneous local ablative therapy and partial hepatectomy for small hepatocellular carcinoma . Ann Surg . 2006;243:321–328
  22. Marrero JA . Hepatocellular carcinoma . Curr Opin Gastroenterol . 2006;22:248–253
  23. Lin SM , Lin CJ , Lin CC , Hsu CW , Chen YC . Randomised controlled trial comparing percutaneous radiofrequency thermal ablation, percutaneous ethanol injection, and percutaneous acetic acid injection to treat hepatocellular carcinoma of 3 cm or less . Gut . 2005;54:1151–1156

PII: S1726-4901(08)70071-6

doi:10.1016/S1726-4901(08)70071-6

Journal of the Chinese Medical Association
Volume 71, Issue 1 , Pages 40-44, January 2008

Article Tools