Successful surgical treatment of peritoneal dissemination of hepatocellular carcinoma.

Hepatocellular carcinoma rarely disseminates intraperitoneally. When it does, it usually is considered a terminal event. The successful treatment of complications of peritoneal metastases by surgical resection in a patient with hepatocellular carcinoma is reported. A 63-year-old man with hepatocellular carcinoma in the anterior segment underwent transarterial and portal embolization followed by extended radical hepatectomy. Five years and 8 months later, he presented with an ileus that was secondary to multiple peritoneal metastases that were resected to the extent possible. Eight months later, the patient presented with a second episode of ileus and underwent another operation that included bowel resection. However, pelvic tumors that were unresectable also were present. The patient survived for another 9 months before dying with peritoneal carcinomatosis. Although surgical treatment of peritoneal dissemination of hepatocellular carcinoma is not curative, surgery may improve survival and provide a good quality of life in selected cases.