ArticleCureus2026
Simultaneous Splenectomy and Partial Hepatectomy for Hepatocellular Carcinoma in a Cirrhotic Patient With Severe Hypersplenism: A Case Report.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Recent Advances in Thalassemia Research: A Comprehensive Assessment From Diagnostic Technologies to Clinical Treatment.Journal of clinical laboratory analysis · 2026Review
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Hepatocellular carcinoma (HCC) often arises in the setting of liver cirrhosis and portal hypertension, which complicates curative treatment strategies. Although liver transplantation represents the gold standard treatment for HCC in cirrhotic patients, severe organ shortage, particularly in Asian countries including Japan, limits its availability. Hypersplenism associated with massive splenomegaly frequently results in severe thrombocytopenia, limiting the feasibility of surgical resection. We report the case of a 55-year-old man with alcohol-related cirrhosis, portal hypertension, and marked pancytopenia who was diagnosed with primary HCC. Liver transplantation was discussed, but was not feasible due to the absence of potential living donors and the prolonged waiting time for deceased donor transplantation in Japan. Imaging revealed a 2-cm hypervascular tumor in segment five of the liver and massive splenomegaly with multiple collateral vessels. Given profound thrombocytopenia (platelet count 32,000/µL), simultaneous splenectomy and partial hepatectomy were performed. The surgery proceeded safely despite advanced cirrhosis (Child-Pugh B, Indocyanine green retention test (ICG-R15) 36%), with perioperative transfusion support. Postoperatively, platelet counts improved rapidly, peaking at 310,000/µL, and liver function stabilized without major complications. Histopathology confirmed moderately differentiated HCC (pT2N0M0, stage II). At the three-month follow-up, no recurrence or portal vein thrombosis was detected, and the patient resumed normal activities. This case highlights the potential role of concomitant splenectomy in selected cirrhotic patients with hypersplenism who are not candidates for liver transplantation, enabling safe hepatic resection and possibly promoting hepatic regeneration through hematologic and hemodynamic mechanisms. However, careful patient selection and vigilant management of splenectomy-related risks remain essential.
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