Treatment and clinical outcome of needle-track seeding from hepatocellular carcinoma

• Published in: Clinical and molecular hepatology Vol. 17; no. 2; pp. 106 - 112
• Main Authors: Ahn, Dong-Won, Shim, Ju Hyun, Yoon, Jung-Hwan, Kim, Chung Yong, Lee, Hyo-Suk, Kim, Yeong Tae, Kim, Yoon Jun
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Association for the Study of the Liver 01.06.2011; The Korean Association for the Study of the Liver; 대한간학회
• Subjects: Adult; Biopsy; Biopsy, Fine-Needle - adverse effects; Carcinoma, Hepatocellular - diagnostic imaging; Carcinoma, Hepatocellular - secondary; Carcinoma, Hepatocellular - therapy; Catheters; Cholangiocarcinoma; Female; Hepatitis B; Hospitals; Humans; Liver cancer; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - pathology; Liver Neoplasms - therapy; Male; Medical imaging; Medical prognosis; Medical records; Middle Aged; Neoplasm Seeding; Original; Patients; Retrospective Studies; Skin Neoplasms - secondary; Tomography, X-Ray Computed; Tumors; Ultrasonic imaging; Ultrasonography; 내과학; United States > US
• ISSN: 1738-222X; 2287-2728; 2093-8047; 2287-285X; 2093-8047
• DOI: 10.3350/kjhep.2011.17.2.106

Needle-track seeding is a rare but important complication of diagnostic and therapeutic ultrasound (US)-guided procedures in hepatocellular carcinoma (HCC). We examined the frequency of needle-track seeding after US-guided percutaneous ethanol injection (PEI), fine-needle aspiration biopsy (FNAB), and percutaneous transhepatic biliary drainage (PTBD) in order to determine the appropriate treatment for needle-track seeding and its clinical outcome. We analyzed the clinical characteristics and treatment outcomes in eight patients who experienced needle-track seeding from HCC after an US-guided procedure (FNAB, PEI, or PTBD) between January 1990 and July 2004. Seven (0.14%) of 5,092 patients who experienced needle-track seeding (2 after PEI, 4 after FNAB, and 1 after PTBD) during the study period and 1 other patient who experienced needle-track seeding recently were recruited for this study. Two of the eight patients underwent mass excision and the other six patients underwent en-bloc wide excision for the needle-track seeding. Tumors recurred in the needle-tracks in both patients who underwent mass excision but not in the six patients who underwent en-bloc wide excision. Mortality occurred in three patients who experienced the recurrence and progression of intrahepatic HCC. The incidence of needle-track seeding after US-guided procedures in HCC was 0.14%. En-bloc wide excision seems to be the optimal treatment for minimizing the probability of tumor recurrence due to needle-track seeding.