Aramaki Masanori, Kawano Katsunori, Sasaki Atsushi, Matsumoto Toshifumi, Kai Seiichiro, Iwashita Yukio, Himeno Yoshihisa, Kitano Seigo
First Department of Surgery, Oita Medical University, 1-1 Idaigaoka, Hasamamachi, Oita 879-5593, Japan.
J Hepatobiliary Pancreat Surg. 2002;9(3):386-8. doi: 10.1007/s005340200046.
We report a patient in whom two pulmonary resections were performed for lung metastasis after hepatic resection of hepatocellular carcinoma (HCC). A 56-year-old Japanese man with an 8-year history of chronic liver disease was admitted with elevated serum alpha-fetoprotein (AFP) and a liver tumor that had been detected by ultrasonography. Computed tomography showed a 6-cm tumor in the medial segment of the liver, and partial resection of the medial segment was performed. Thirty-six months after the first operation, pulmonary resection was performed for a solitary metastasis in the left lung. Fifty-one months after the second operation, a solitary metastatic tumor was detected in the right lung, without any evidence of recurrence or other metastatic foci, and thoracoscopic partial resection of the right lung was performed as the third operation. The patient is alive 36 months after the second pulmonary resection, has a normal AFP value, and shows no signs of recurrent or metastatic foci. Repeat pulmonary resection for metastasis from HCC resulted in long-term survival in this patient.
我们报告了一名肝细胞癌（HCC）肝切除术后因肺转移接受两次肺切除术的患者。一名有8年慢性肝病病史的56岁日本男性因血清甲胎蛋白（AFP）升高及超声检查发现肝脏肿瘤入院。计算机断层扫描显示肝脏中叶有一个6厘米的肿瘤，遂行中叶部分切除术。首次手术后36个月，因左肺单发转移瘤行肺切除术。第二次手术后51个月，在右肺发现一个单发转移瘤，无复发或其他转移灶迹象，遂行胸腔镜下右肺部分切除术作为第三次手术。患者在第二次肺切除术后36个月仍存活，AFP值正常，无复发或转移灶迹象。该患者因HCC转移灶行再次肺切除术后获得长期生存。
