European Journal of Ultrasound 6 (1997) 185 – 189
Clinical report
Relapsing neoplastic seeding after percutaneous ethanol
injection for hepatocellular carcinoma. Clinical and
ultrasonographic findings in a cirrhotic patient
Giampiero Francica
a,
*, Gianpiero Marone
a
, Valentina D’Angelo
a
, Giuseppe Iodice
a
,
Pietro Pastore
a
, Maria Elisa Albo
b
, Gabriella Altamura
c
, Antonio De Falco
d
,
Luigi Sauchelli
d
a
Diisione di Gastroenterologia, Ospedale ‘Cardinale Ascalesi’ —ASL Napoli 1, Via Egiziaca a Forcella 13, Napoli, Italy
b
Serizio di Anestesia e Rianimazione, Ospedale ‘Cardinale Ascalesi’ —ASL Napoli 1, Via Egiziaca a Forcella 13, Napoli, Italy
c
Serizio di Radiologia; Ospedale ‘Cardinale Ascalesi’ —ASL Napoli 1, Via Egiziaca a Forcella 13, Napoli, Italy
d
Unita’ Operatia di Chirurgia Laparoscopica e Miniinasia, Ospedale ‘Cardinale Ascalesi’ —ASL Napoli 1,
Via Egiziaca a Forcella 13, Napoli, Italy
Received 9 June 1997; received in revised form 24 September 1997; accepted 29 September 1997
Abstract
A case of neoplastic implant after percutaneous ethanol injection (PEI) therapy for hepatocellular carcinoma
(HCC) occurring in two steps is described. A 74-year-old male cirrhotic patient underwent PEI for a 5-cm HCC
nodule. To obtain complete tumoral necrosis, 80 ml were injected under sonographic guidance in four sessions. Ten
months after the completion of PEI a subcutaneous nodule was palpated in the abdominal wall within the area of
needle punctures. Histologic examination of the excised nodule confirmed the sonographic and Power Doppler
diagnosis of metastatic HCC. At the US exam scheduled three months later a non-palpable subcutaneous nodule of
16 mm was appreciated near the surgical wound. Once again metastatic HCC was demonstrated at pathological
examination. © 1997 Elsevier Science Ireland Ltd.
Keywords: Ultrasound; Hepatocellular carcinoma; Percutaneous ethanol injection; Needle track seeding
* Corresponding author. Via Onofrio Fragnito, 2, 80131 Napoli, Italy. Tel.: +39 81 5455283; fax: +39 81 284227; e-mail:
gfrancica@mbx.idn.it
0929-8266/97/$17.00 © 1997 Elsevier Science Ireland Ltd. All rights reserved.
PII S0929-8266(97)10015-5