Cystadenoma of the liver treated by hepatic resection

The aim of this study is to report a case of cystadenoma in the liver and to discuss the difficulty of differential diagnosis from malignant tumor and the importance of complete resection of the lesion. The patient had epigastric pain and abdominal distension. Hepatic ultrasonography, abdominal CT, magnetic resonance imaging, and angiography showed the presence of a large cystic tumor occupying the right hepatic lobe indicating malignant cystadenocarcinoma. Needle biopsy of the cyst wall with sampling of the cyst fluid was performed, which revealed no malignant cells. However, CEA and CA19-9 were markedly elevated in the cyst fluid. A right trisegmentectomy via laparotomy was performed successfully. The resected tumor was 11.5x9x9 cm in size and weighed 1,240 g. The cut surface revealed the tumor with multiple cysts, in some parts of which large papillary projections into lumina were seen. Though the gross features were similar to those of cystadenocarcinoma, the final histological diagnosis was benign cystadenoma of the liver. The postoperative course was uneventful, and the patient is in good condition six years postoperatively without evidence of recurrence of the disease.

Increased expression of c-jun gene during spontaneous hepatocarcinogenesis in LEC rats

We have studied the expressions of nine proto-oncogenes (c-myc, N-myc, c-fos, C-jun, p53, H-ras, N-ras, c-raf, hst) and two other genes (PCNA, GST-P) during the spontaneous development of hepatocellular carcinomas (HCCs) in LEC rats. Expression of c-myc, H-ras, N-ras, C-raf, p53 and PCNA genes was detected, but this did not significantly change during the development of HCCs in LEC rats. Expression of N-myc and hst genes was not detectable. Expression of c-fos gene was detected in one HCC case out of four. Significantly increased expression of c-jun gene was observed in the liver tissues of LEC rats aged 8 months. This high expression was decreased with the development of HCCs. On the other hand, the expression of GST-P gene increased in parallel with the clinical course of the development of HCCs in LEC rats. The pattern of c-jun mRNA augmentation was different from that of GST-P mRNA. These observations suggest that c-jun gene may play a role in the spontaneous development of HCCs in LEC rats.

[A case of double cancer of gastric and hepatocellular carcinoma associated with cirrhosis treated by hepatic resection after intra-hepatic arterial infusion chemotherapy]

A case of double cancer, early gastric cancer and hepatocellular carcinoma, was reported. The patient was diabetic and had liver cirrhosis. After gastrectomy for gastric cancer which was hemorrhagic, he was treated by intra-hepatic arterial infusion chemotherapy followed by hepatic resection. Histopathologically, about half of the main tumor showed necrosis, but very viable new cancer cell nests were seen around the main nodule. The patient is in good condition without recurrence of hepatic lesion 1 year after resection. The usefulness of arterial infusion chemotherapy was demonstrated in the case of double cancer, in which it is difficult to resect both cancers simultaneously.