A successful treatment for hepatocellular carcinoma with Osler–Rendu–Weber disease using radiofrequency ablation under laparoscopy

Hepatocellular carcinoma (HCC) can be difficult to diagnose and treat in patients with Osler–Rendu–Weber disease due to vascular malformation and regenerative nodular hyperplasia. In addition, percutaneous liver puncture should be avoided for the diagnosis and treatment as the procedure carries a high risk of bleeding. We herein report the successful treatment of HCC in a patient with Osler–Rendu–Weber disease using radiofrequency ablation (RFA) under laparoscopy. A 71-year-old man with Osler–Rendu–Weber disease was admitted to our hospital for the treatment of HCC. He also had chronic hepatitis C virus infection. The arterioportal shunts in the liver were detected by computed tomography (CT) and angiography. A tumor 20 mm in size was detected as a defected-lesion in the hepatic segment IV during the portal phase by CT. RFA under laparoscopy was performed for the curative treatment for HCC, with sufficient ablation obtained. Although the blood gushed out from the needle tract at the end of the procedure, complete hemostasis was achieved promptly using coagulation forceps. The post-operative course was favorable. Thus, laparoscopic RFA is a useful treatment modality for HCC in patients with Osler–Rendu–Weber disease, as a hemostasis device can be used with direct visualization.