A case of hematogenous metastasis of the rectus abdominis muscle from hepatocellular carcinoma decreased by transcatheter arterial infusion

Abstract

Following type C liver cirrhosis, a 68-year-old woman was found to have tumors of the right lower abdomen and liver. Abdominal computed tomography (CT) showed enhanced tumors in the left lobe of the liver and the right rectus abdominis muscle. We conducted transcatheter arterial infusion (TAI) to the left and middle hepatic arteries for the liver tumor and to the right inferior epigastric artery for the tumor in the right rectus abdominis muscle using lipiodol and epirubisin. About a month later, the liver tumor had decreased slightly and the tumor in the rectus abdominis muscle had decreased notably. We resected the tumor in the rectus abdominis muscle, for TAI was necessary rather than hepatectomy because of the bad reverse function of the liver and the absence of abdominal wall was small. Histological findings for the resected specimen were necrotic, but we diagnosed metastasis of the rectus abdominis muscle from hepatocellular carcinoma by viable cells. About five months later, the tumor in the right rectus abdominis muscle has not been recurrent. Metastasis of the rectus abdominis muscle from hepatocellular carcinoma is extremely rare without abdominal percutaneous procedures such as percutaneous liver biopsy and percutaneous ethanol injection. Our case is to our knowledge the first involving TAI for metastasis of the rectus abdominis muscle from hepatocellular carcinoma, and this therapy was extremely effective.