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Abstract: A 38-year-old young female patient was found to have a hepatic occupancy on physical examination, which showed a very enhanced arterial phase on intensive CT, and a venous phase that also showed shadowing, which is typical of hepatocellular adenoma. The patient’s tumor had a diameter of 2.5 centimeters, and after communication with the patient, radiofrequency ablation was given for minimally invasive treatment.
Basic information】Female, 38 years old
Disease Type】Hepatocellular adenoma
Hospital】Liaocheng People’s Hospital
Date of consultation】November 2021
Treatment plan】Minimally invasive surgery (radiofrequency ablation)
Treatment Period】Discharge from hospital 3 days after surgery, outpatient review 1 month later
Treatment effect】Tumor basically disappeared, good postoperative recovery
I. Initial consultation
A young woman came to see me today, she was nervous and said she had a tumor on her liver, and the CT report reported hepatic adenoma. She did not understand whether the tumor was benign or malignant and how to treat it next, and she was very anxious. In the outpatient clinic, we communicated with the patient that this tumor was most likely to be a hepatic adenoma from the enhanced CT, but we could not completely rule out the possibility of malignancy or malignancy. The best treatment plan is to remove the tumor by inpatient surgery, and the patient agreed to the surgery and inpatient treatment.
II. Treatment process
After admission, the patient was routinely examined. The patient had no viral hepatitis, and the tumor markers glycoconjugate antigen 19-9, carcinoembryonic antigen and methemoglobin were all normal. This condition also indicated that this tumor on the liver was more likely to be benign and less likely to be a malignant tumor or metastatic tumor. After communicating with the patient’s family and explaining the risks of surgery, the patient’s family said that this surgery was too traumatic and risky and wanted to see if there were other treatment options. Then another minimally invasive treatment was recommended to the patient, which is radiofrequency ablation. This kind of radiofrequency ablation is suitable for liver tumors smaller than 3cm. Through the radiofrequency needle puncture to the tumor, the tumor will be burned off by energy, which can also play the same treatment effect as surgical removal. The patient also agreed to this treatment plan, and radiofrequency ablation of liver tumor was done to the patient. The operation time was 20 minutes, and the operation was very smooth, and the trauma was also very small.
III. Treatment effect
The patient recovered very smoothly after the surgery, because the radiofrequency ablation procedure is short and very little trauma, avoiding the trauma and risk of open surgery. Radiofrequency ablation is suitable for liver tumor less than 3 centimeters. After the postoperative review of CT, the patient’s liver tumor basically disappeared, achieving the same treatment effect as surgical resection, and the patient was very satisfied with the treatment effect. The patient resumed normal life 3 days after the operation and was granted discharge, and the patient was instructed to review the outpatient clinic in 1 month.
IV. Notes
We are glad that the patient was able to detect the tumor and take treatment measures in time, but we still need to advise the patient to gradually increase the diet and nutrition and pay attention to rest after discharge, so that he can resume normal life and work in about 2 weeks.
After 1 month of radiofrequency ablation, patients should go to the outpatient clinic once to review the blood routine, liver function and abdominal CT, mainly to understand the patient’s postoperative recovery. In addition, you should review regularly, once every 6 months, because this kind of benign tumor may grow again, after all, it is not a radical surgery, and there is also a possibility that incomplete treatment may lead to tumor recurrence. If tumor recurrence is found, radiofrequency ablation can be considered again, or radical resection can be chosen directly. If the disease has been stable, the review time can be extended to once a year.
V. Personal insight
The incidence of liver tumor is getting higher and higher, and it is divided into benign tumor and malignant tumor. There are many means of treatment, such as traditional open surgery, minimally invasive laparoscopic surgery, radiofrequency ablation and interventional surgery, which can achieve better treatment effect for different tumors and different conditions. The treatment of liver tumor is still based on individualized treatment. Like our patient, the tumor is relatively small and benign, and she does not want to face too much risk and trauma of surgery, so she chose radiofrequency ablation and achieved the same therapeutic effect as surgical resection.