case_images: PMC6188071_01
case_images: Left: Preoperative abdominal CT. Solid hepatic lesion at segments VI and VII (arrows) and calcified lesion at the tail of the pancreas (circle). Right: Postoperative abdominal CT. Subcapsular hepatic fluid collection without recurrence of the HCC (circle).. Abbreviations: CT, computed tomography; HCC, hepatocellular carcinoma.
case_images: ijgm-11-399Fig1.jpg
case_images: PMC6188071_01_ijgm-11-399Fig1.jpg
case_images: f1-ijgm-11-399
case_images: Seven years after the initial treatment for breast cancer, abdominal CT revealed a solid hepatic lesion at segments VI and VII measuring 7 cm in diameter as well as a 1 cm calcified lesion at the tail of the pancreas (Figure 1, left). Follow-up abdominal CT scanning on the first and sixth month after the operation showed subcapsular hepatic fluid collection without recurrence of the HCC (Figure 1, right).
case_images: (A) Scar lesion from the pancreas (H&E 100X). (B) The tumor cells are arranged in abnormal and thick trabeculae (H&E 100X). (C) The neoplastic cells are positive for HepPar1 (Immunostain 200X). (D) The neoplastic cells are positive for AFP (Immunostain 200X).
case_images: ijgm-11-399Fig2.jpg
case_images: PMC6188071_01_ijgm-11-399Fig2.jpg
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case_images: Moreover, after entering the lesser sac, a second rapid biopsy was taken from the lesion at the pancreatic tail which showed chronic fibrosis without elements of malignancy (Figure 2A). Immunohistochemistry showed that cancer cells highly expressed keratins 8/18, Hep-Par 1 and AFP and did not express keratin 7 and GATA-3 (Figure 2B-D).
case_images: Left: Intraoperative photo. Microwave tissue coagulator marking the margins for hepatic segmentectomy. Right: Gross specimen photo. Hepatic segments VI and VII containing the HCC.. Abbreviation: HCC, hepatocellular carcinoma.
case_images: ijgm-11-399Fig3.jpg
case_images: PMC6188071_01_ijgm-11-399Fig3.jpg
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case_images: Hepatic segmentectomy was achieved using a microwave tissue coagulator to mark and coagulate the margins of hepatectomy and ultrasound harmonic scalpel to transect the hepatic parenchyma with a minimal blood loss of 40 cc (Figure 3).