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Three cases of regenerating hyperplastic nodule in the cirrhotic liver are reported in detail. The patients were all men, ranging in age from 41 to 57 years. They were all heavy drinkers and had chronic liver disease for 6 to 10 years. All patients had slightly elevated alpha-fetoprotein levels and were positive for HBs and HBc antibodies. Radiologic findings were not uniform except for ultrasonography, which demonstrated the lesion in all cases. Preoperative diagnosis was hepatocellular carcinoma (HCC) or highly suspicious of HCC in all of them. At laparotomy, all lesions were embedded in the liver parenchyma and invisible from the hepatic surface. With the aid of intraoperative sonography, partial hepatic resections were performed. Pseudocapsule was seen in two cases. Definitive differential diagnosis of regenerating nodules from HCC in the cirrhotic liver was extremely difficult. The authors propose the name "hepatocellular pseudotumor in the cirrhotic liver" to describe such lesions.

During the last 3 years and 9 months, hepatic resections were carried out on 60 patients with hepatocellular carcinoma (HCC). The resections were radical in 44 and palliative in 16 cases. Simultaneous operations were performed for oesophageal varices in 11 (9 prophylactic and 2 therapeutic) and for cholelithiasis in 9 patients. Fifty-nine patients had underlying hepatic disease; 52 had cirrhosis and 7 chronic hepatitis. Operative mortality rate within 1 month was 10 per cent and overall hospital mortality rate was 16.7 per cent. Excluding operative and hospital deaths, 76.8 per cent of patients who had radical excision and 18.8 per cent with palliative resections are alive. The result indicates that HCCs are frequently resectable even in the presence of liver cirrhosis provided that they are discovered at a relatively early stage.