Pedunculated hepatoma--report of two cases and review of the literature.

Although pedunculated hepatoma has received little attention in the United States and Europe, in Japan more than forty cases have been reported, probably owing to the relatively high frequency of hepatoma. Formerly preoperative diagnosis was difficult in the early period. Recently it can be made by ultrasound, computed tomography and angiography, however, the choice of operative procedure is not uniform. In some cases good results were obtained by only tumor excision or partial hepatic resection, whereas other cases presented undergoing more extended resection show a poorer course. In the present case 1, intrahepatic recurrence was recognized three months after surgery in spite of relatively early diagnosis. Reviewing the literature, it appears that the degree of invasion at the pedicle is mainly related to prognosis. If invasive, segmentectomy or lobectomy is necessary and postoperative adjuvant therapy is needed.