Case-report. Metastases in a low-stage middle-graded HCC in cleared HCV infection, non-cirrhotic liver. Surgical therapy

Introduction Hepatocellular carcinoma (HCC) is rare in non-cirrhotic liver. Achievement of sustained virological response (SVR) reduces even more the risk. Presentation of case Liver resection for small HCC was performed in cleared HCV infection non-cirrhotic 62-year-old man. Methacronous oligometastatic recurrences in intolerant to Nexavar® side-effects patient, were treated by multiple innovative microinvasive approaches: bilateral laparoscopic adrenalectomy, thoracic wall resection, laparoscopic sacrum cryoablation combined with hadron-therapy. Discussion Therapies allowed the patient to lead 6 years satisfying QoL with only a small residual presacral disease stable at 8 months. Conclusion Microinvasive surgery may be a valid resource of therapy in indolent HCC limited distant recurrences.