Yamamoto H, Watanabe K, Nagata M, Yano Y, Akai T, Honda I, Watanabe S, Soda H, Matsuzaki O
Division of Gastroenterological Surgery, Chiba Cancer Center Hospital, Japan.
Jpn J Clin Oncol. 1999 Sep;29(9):445-7. doi: 10.1093/jjco/29.9.445.
A 21-year-old man had undergone central bisegmentectomy of the liver due to fibrolamellar carcinoma (FLC). Twice, 24 and 30 months after the first operation, lymph node metastases were removed. We have reported this case previously and this is the second report of the same case. Forty-two months after the second operation to remove lymph node metastases, a recurrence occurred in the rectum and was excised. However, the tumor also recurred in the residual liver. The patient underwent hepatectomy for a palliative purpose but died 16 months after the last operation. Histopathologically, the primary tumor was diagnosed as pure FLC, but the lymph node metastases had foci of the common hepatocellular carcinoma (HCC) mixed with FLC. In contrast, the recurrent tumors in the rectum and the residual liver showed the histopathological features of common HCC. Thus, during repeated recurrences, histopathological features changed from pure FLC to common HCC.
一名21岁男性因纤维板层癌（FLC）接受了肝脏中央双段切除术。首次手术后24个月和30个月，两次切除了淋巴结转移灶。我们之前已报道过该病例，这是同一病例的第二次报告。在第二次切除淋巴结转移灶的手术后42个月，直肠出现复发并进行了切除。然而，肿瘤也在残留肝脏中复发。患者接受了姑息性肝切除术，但在最后一次手术后16个月死亡。组织病理学检查显示，原发性肿瘤被诊断为纯FLC，但淋巴结转移灶有普通肝细胞癌（HCC）与FLC混合的病灶。相比之下，直肠和残留肝脏中的复发性肿瘤表现出普通HCC的组织病理学特征。因此，在反复复发过程中，组织病理学特征从纯FLC转变为普通HCC。
