Huang Hsu-Kai, Lin Chien-Hua, Hsu Chia-Chun, Yu Jyh-Cherng, Liu Yao-Chi, Chen Teng-Wei, Hsieh Chung-Bao
Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
N Z Med J. 2007 Jun 1;120(1255):U2562.
A 34-year-old male was admitted for recurrent hepatocellular carcinoma (HCC) with poor healing of a radiofrequency ablation wound over the subxiphoid region. The patient underwent lobectomy of the liver 3 years previously. Transarterial chemoembolisation was performed twice for tumour recurrence, and radiofrequency ablation was done for new recurrence 2 months previously. Due to poor healing with discharge through the puncture wound and elevated alpha feto-protein (AFP) level, recurrent hepatocellular carcinoma and tumour seeding of the needle tract were suspected. During surgery, a recurrent tumour mass over segment 3 with a hepatocutaneous fistula within the adhesion tissue between the liver surface and abdominal wall was discovered. We recommend that hepatocutaneous fistula should be considered as a complication of radiofrequency ablation for hepatic tumours.
一名34岁男性因复发性肝细胞癌（HCC）入院，剑突下区域的射频消融伤口愈合不良。该患者3年前接受了肝叶切除术。因肿瘤复发进行了两次经动脉化疗栓塞，2个月前对新出现的复发灶进行了射频消融。由于穿刺伤口愈合不佳且有分泌物，以及甲胎蛋白（AFP）水平升高，怀疑有复发性肝细胞癌和针道肿瘤种植。手术中，在肝表面与腹壁之间的粘连组织内发现了3段的复发性肿瘤肿块及肝皮瘘。我们建议肝皮瘘应被视为肝肿瘤射频消融的一种并发症。
