Komori Takamichi, Sasaki Yo, Yamada Terumasa, Ohigashi Hiroaki, Ishikawa Osamu, Inoue Etsuo, Ishiguro Shingo, Seki Toshihito, Imaoka Shingi
Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higasinari-ku, Osaka 537-8511, Japan.
Surg Today. 2004;34(1):76-9. doi: 10.1007/s00595-003-2649-5.
We report the case of a 45-year-old man with advanced hepatocellular carcinoma (HCC) who was able to undergo radical surgery after repeated transarterial therapy. Transarterial chemoembolization was repeated three times, and thereafter, transarterial infusion chemotherapy using Lipiodol was performed on the right hepatic artery. Because notable atrophy of the right lobe and compensated hypertrophy of the left lobe were detected after this therapy, an extended right lobectomy could be performed. Histologically, the HCC showed complete necrosis. The remarkable atrophic change of the right lobe was thought to be due to an obstruction of the right portal veins by the spread of inflammation around the bile duct necrosis, in addition to the narrowing of the hepatic artery. A thorough understanding of this phenomenon and the development of methods to clinically apply it in the treatment of cancer patients may thus lead to an increase in the percentage of resectable cases of advanced HCC.
我们报告了一例45岁晚期肝细胞癌（HCC）男性患者的病例，该患者在接受多次经动脉治疗后能够接受根治性手术。经动脉化疗栓塞术重复进行了三次，此后，对右肝动脉进行了使用碘油的经动脉灌注化疗。由于该治疗后检测到右叶明显萎缩和左叶代偿性肥大，因此可以进行扩大右叶切除术。组织学检查显示，HCC呈现完全坏死。右叶的显著萎缩变化被认为是由于胆管坏死周围炎症扩散导致右门静脉阻塞，以及肝动脉狭窄所致。因此，深入了解这一现象并开发将其临床应用于癌症患者治疗的方法，可能会提高晚期HCC可切除病例的比例。
