Hepatocellular Carcinoma Recurrence with Metachronous Peritoneal Metastasis - A Controversial Surgical Indication

Intraperitoneal metastases of a non-ruptured HCC are rare. Metastatic disease is an expression of an advanced disease, is associated with poor prognosis and can occur at the time of hepatic recurrence. We present the case of a female patient who underwent surgery for a big hepatic adenoma that suffered malignant transformation. Fifteen months later, she had HCC liver recurrence with peritoneal metastases, being submitted to a new surgery with complete resection of the hepatic mass and peritoneal implants. In the absence of HCC rupture, peritoneal dissemination is not common. Aggressive surgical treatment and adjuvant treatment with sorafenib could prolong patients’ overall survival but there is still no standard management for these patients.