New unroofing technique to secure effective microwave coagulation therapy for deeply located hepatocellular carcinoma: A case report

This report describes a new unroofing technique to secure an effective microwave coagulation therapy (MCT) for a case of hepatocellular carcinoma, which was deeply located in segment 5 adjacent to the confluence of right anterior and posterior portal pedicles. A 62 year-old man developed HCC in the context of liver cirrhosis caused by hepatitis C virus. Transcatheter arterial embolization was attempted initially because of the tumor location and poor hepatic functional reserve, but failed to achieve satisfactory remission. On laparotomy, hepatic parenchyma was superficially resected to uncover the ventral surface of deeply located HCC adjacent to major hepatic vessels, enabling an accurate as well as effective MCT. The patient has been alive and well without recurrence for five months following the surgery.