Case Report
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World J Hepatol. Aug 27, 2010; 2(8): 318-321
Published online Aug 27, 2010. doi: 10.4254/wjh.v2.i8.318
Surgical treatment of HCC in a patient with lamivudine-resistant hepatitis B cirrhosis with adefovir dipivoxil
Takashi Akima, Masaya Tamano, Hidetsugu Yamagishi, Keiichi Kubota, Takahiro Fujimori, Hideyuki Hiraishi
Takashi Akima, Hideyuki Hiraishi, Department of Gastroenterology, Dokkyo Medical University, Tochigi 321-0293, Japan
Masaya Tamano, Department of Gastroenterology, Dokkyo Medical University Koshigaya Hospital, Saitama 343-8555, Japan
Hidetsugu Yamagishi, Takahiro Fujimori, Department of Surgical and Molecular Pathology, Dokkyo Medical University, Tochigi 321-0293, Japan
Keiichi Kubota, Second Department of Surgery, Dokkyo Medical University, Tochigi 321-0293, Japan
Author contributions: Akima T and Tamano M did the research of this project and wrote the case report; Yamagishi H and Fujimori T did the pathological examinations; Kubota K did the hepatectomy; and Hiraishi H is the head of Department of Gastroenterology.
Correspondence to: Masaya Tamano, Professor, Department of Gastroenterology, Dokkyo Medical University Koshigaya Hospital, 2-1-50 Minami-Koshigaya, Koshigaya-Shi, Saitama 343-8555, Japan. mstamano@dokkyomed.ac.jp
Telephone: +81-48-965-1111 Fax: +81-48-965-1169
Received: April 16, 2010
Revised: July 1, 2010
Accepted: July 8, 2010
Published online: August 27, 2010
Abstract

We describe a 77-year-old woman with chronic hepatitis B who became resistant to lamivudine. She was started on adefovir (10 mg daily) while still continuing lamivudine therapy. Four mo later her liver function improved and serum Hepatitis B virus (HBV)-DNA level became undetectable. Three years after the start of additional adefovir treatment, hepatocellular carcinoma (HCC) was detected and the patient underwent a successful hepatectomy. Our findings suggest that the addition of adefovir to ongoing lamivudine therapy cannot completely suppress hepatocarcinogenesis, but is useful for improving liver function in patients with lamivudine-resistant HBV-related cirrhosis, allowing HCC surgery.

Keywords: Hepatitis B virus; Hepatocellular carcinoma; Hepatocarcinogenesis; Lamivudine; Adefovir dipivoxil