Case Report
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World J Gastroenterol. May 28, 2012; 18(20): 2586-2590
Published online May 28, 2012. doi: 10.3748/wjg.v18.i20.2586
Lamivudine treatment enabling right hepatectomy for hepatocellular carcinoma in decompensated cirrhosis
Koichi Honda, Masataka Seike, Shin-ichiro Maehara, Koichiro Tahara, Hideaki Anai, Akira Moriuchi, Toyokichi Muro
Koichi Honda, Masataka Seike, First Department of Internal Medicine, Oita University, Oita 879-5593, Japan
Shin-ichiro Maehara, Koichiro Tahara, Hideaki Anai, Department of Surgery, National Hospital Organization Oita Medical Center, Oita 870-0263, Japan
Akira Moriuchi, Department of Pathology, National Hospital Organization Oita Medical Center, Oita 870-0263, Japan
Toyokichi Muro, Department of Gastroenterology and Hepatology, National Hospital Organization Oita Medical Center, Oita 870-0263, Japan
Author contributions: Honda K wrote the manuscript; Honda K, Maehara S, Tahara K, Anai H and Muro T performed the clinical work; Moriuchi A discussed the pathology results; and Seike M reviewed the paper.
Correspondence to: Koichi Honda, MD, PhD, First Department of Internal Medicine, Oita University, 1-1 Hasama-machi, Yufu City, Oita 879-5593, Japan. hondak@oita-u.ac.jp
Telephone: +81-97-5865793  Fax: +81-97-5494480
Received: November 21, 2011
Revised: February 15, 2012
Accepted: March 9, 2012
Published online: May 28, 2012
Abstract

A 69-year-old man was admitted to our hospital in October 2003, for further examination of two liver tumors. He was diagnosed with hepatocellular carcinoma (HCC) arising from decompensated hepatitis B virus (HBV)-related cirrhosis. Long-term lamivudine administration improved liver function dramatically despite repeated treatment for HCC. His Child-Pugh score was 9 points at start of lamivudine treatment, improving to 5 points after 1 year. His indocyanine green at 15 min after injection test score was 48% before lamivudine treatment, improving to 22% after 2 years and to 5% after 4 years. Radiofrequency ablation controlled the HCC foci and maintained his liver function. In April 2009, abdominal computed tomography revealed a tumor thrombus in the right portal vein. Since his indocyanine green test results had improved to less than 10%, we performed a right hepatectomy, which was successful. To our knowledge, there have been no documented reports of patients undergoing successful right hepatectomy for HCC arising from decompensated cirrhosis. The findings observed in our patient indicate the importance of nucleoside analogs for treating HBV-related HCC.

Keywords: Hepatitis B virus; Lamivudine; Hepatocellular carcinoma; Decompensated cirrhosis; Hepatectomy