Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 7, 2016; 22(41): 9242-9246
Published online Nov 7, 2016. doi: 10.3748/wjg.v22.i41.9242
Metabolic imaging for guidance of curative treatment of isolated pelvic implantation metastasis after resection of spontaneously ruptured hepatocellular carcinoma: A case report
Bing Hao, Wei Guo, Na-Na Luo, Hao Fu, Hao-Jun Chen, Long Zhao, Hua Wu, Long Sun
Bing Hao, Wei Guo, Na-Na Luo, Hao Fu, Hao-Jun Chen, Long Zhao, Hua Wu, Long Sun, Department of Nuclear Medicine and Minnan PET Center, Xiamen Cancer Hospital, the First Hospital of Xiamen University, Xiamen 361003, Fujian Province, China
Author contributions: All authors contributed to the acquisition of data and the writing and revision of this manuscript.
Supported by National Science Foundation for Yong Scholars of China, No. 81101067.
Institutional review board statement: This case report was exempt from the Institutional Review Board standards at Xiamen University in Xiamen.
Informed consent statement: The patient involved in this study gave her written informed consent authorizing use and disclosure of her protected health information.
Conflict-of-interest statement: All the authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Long Sun, MD, Department of Nuclear Medicine and Minnan PET Center, Xiamen Cancer Hospital, the First Hospital of Xiamen University, Xiamen 361003, Fujian Province, China. 13178352662@163.com
Telephone: +86-0592-2137077
Received: May 8, 2016
Peer-review started: May 9, 2016
First decision: June 20, 2016
Revised: July 9, 2016
Accepted: August 1, 2016
Article in press: August 1, 2016
Published online: November 7, 2016
Processing time: 181 Days and 20.8 Hours
Abstract

Spontaneous rupture of hepatocellular carcinoma (HCC) is a life-threatening complication and its prognosis is significantly poor because of the high recurrence rate after initial hepatectomy. Resection of isolated extrahepatic metastasis of HCC has been advocated to obtain a possibility of long-term survival. However, it is a challenge for clinicians to detect implantation metastasis of spontaneously ruptured HCC. Accurate re-staging plays the most important role in making a decision on isolated metastasis resection. 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) is useful in detecting intra-abdominal implantation metastasis from a variety of malignancies and shows superior accuracy to conventional imaging modalities in determining the location of metastasis. We present one patient with a new isolated pelvic implantation metastasis detected by 18F-FDG PET/CT and pathologically confirmed by PET/CT-guided percutaneous biopsy, who had a history of resection of spontaneously ruptured HCC two years ago. The patient’s condition was stable at the 6-mo follow-up after resection of the isolated pelvic metastasis.

Keywords: Fluorodeoxyglucose; Positron emission tomography/computed tomography; Spontaneously ruptured hepatocellular carcinoma; Isolated pelvic implant metastasis; Re-staging; Surgical resection

Core tip: Spontaneous rupture of hepatocellular carcinoma is a life-threatening complication and its prognosis is significantly poor. It is a challenge for clinicians to detect implantation metastasis. Accurate re-staging plays the most important role in making a decision on isolated metastasis resection.18F-fluorodeoxyglucose positron emission tomography/computed tomography is useful in detecting intra-abdominal implantation metastasis from a variety of malignancies and shows superior accuracy to conventional imaging modalities in determining the location of metastasis.