Resected multiple hepatocellular carcinoma associated with Wilson's disease presenting with neurological complication: Report of a case

A 54-year-old female with Wilson's disease had been treated with D-penicillamine for 24 years. A hyper-vascular hepatic tumor was found in S6 and it was diagnosed as a hemangioma at that time. Seventeen months later, the hepatic tumor number and size increased. There were more than 4 tumors and the maximum size of the tumor was over 5 cm. The liver function was evaluated as Child-Pugh Grade A. These tumors were diagnosed as multiple HCC and transcatheter arterial chemoembolization was performed. Six weeks later, CT showed viable lesions and all tumors existed in S5-6. The neurological symptoms were stable, and therefore all of the tumors were removed by a hepatic resection (S5-6). A pathological examination showed liver cirrhosis and all tumors were moderately differentiated HCC. No copper deposition was observed with rhodamine stain. The post-operative course was good and both the liver function and neurological signs have since remained stable. No tumor has appeared during the 14 months post-operative period.