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Challenging case 4kg tumour fibrolamellar HCC, 12-hr surgery

Approximately two months ago Dr. Prof. Tom Cherian, Head of the Liver Transplant team at CARE Hospital, had an unusual patient from Nigeria. A young man of just 19, presented with a tumour that on CT scanning was found to be approximately 4000 ml in volume and 21 cms in size, positioned right in the centre of his liver. The radiological diagnosis was a potential hepatocellular cancer (HCC), which has a poor response to chemo or radiotherapy. The only hope of a cure was with surgery although a small risk of disease recurrence existed.

Speaking on the unique situation Prof. Dr. Tom Cherian said, “At first look it appeared an impossible task. The tumour involved almost 6 out of 8 lobes of the liver and was running very close to all the crucial vessels supplying blood to this vital organ. Moreover there was obstruction to the flow of bile due to the tumour, resulting in high bilirubin levels (Jaundice). However given the age of the patient and the fact that without surgery his life was limited to a few months, I felt we had to try. The family was warned about the risks and with a deep faith in God …

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