@article{oai:yamagata.repo.nii.ac.jp:00000228,
 author = {平井,  一郎 and 木村,  理 and 大泉,  弘幸 and 藤本,  博人 and 渡邊,  利広 and 手塚,  康二 and 山岸,  岳人 and 菅原,  秀一郎 and 金内,  直樹 and 塩野,  知志 and 皆川,  忠徳 and 貞弘,  光章},
 issue = {1},
 journal = {山形大学紀要. 医学 : 山形医学 = Bulletin of the Yamagata University. Medical science : Yamagata medical journal},
 month = {Feb},
 note = {論文(Article), Spontaneous rupture of hepatocellular carcinoma (HCC) is sometimes encountered clinically. We experienced a case of spontaneous rupture of a HCC, which was surgically resected along with the diaphragm.A 74-year old woman presented with anemia. Preoperative imaging suggested a tumor arising on the diaphragm. After thoracotomy and laparotomy, the intraoperative diagnosis was changed to spontaneous rupture of a HCC with invasion to the diaphragm and right lower lung. Wide resection of the diaphragm including an area measuring 13×10 cm, partial resection of the right lower lung and right hepatectomy were performed. The defect in the diaphragm was reconstructed by suturing with a reversed latissimus dorsi muscle flap.There was no recurrence of HCC 7 years after surgery. Furthermore, the patient had no muscle weakness in the right arm during daily living activities.In conclusion, a good outcome may be obtained by combined resection of a ruptured HCC along with the diaphragm, even if the tumor has infiltrated the diaphragm. A latissimus dorsi muscle flap is considered to have a better antibacterial effect than an artificial mesh prosthesis, and is suitable for patients requiring wide resection of the diaphragm.},
 pages = {29--35},
 title = {A case of spontaneous rupture of hepatocellular carcinoma mimicking a diaphragm tumor: Reconstruction of the diaphragm using a latissimus dorsi muscle flap},
 volume = {32},
 year = {2014}
}