Lim Joo Han, Lee Jin-Woo, Kim Eun Joo, Lee Jung Il, Jeong Seok, Lee Don Haeng, Shin Yong Woon, Kim Joon Mee
Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea.
Korean J Gastroenterol. 2007 Jul;50(1):66-9.
Extrahepatic recurrence of hepatocellular carcinoma (HCC) has been considered unsuitable for surgical resection since the disease is considered to be extensive. However, solitary local lymph node recurrence in small HCC is rarely reported with suitable treatment modality being uncertain. We herein, present a case of 60-year-old female patient with small HCC showing late lymph node metastasis after complete resection of primary HCC. A 2 cm-sized hepatic mass was completely resected by segmentectomy (VIII). Eight months later, CT and PET scan revealed a 4.5 cm-sized portocaval lymph node (LN). In addition, whole body PET/CT scan strongly suggested a solitary tumor recurrence. Radical lymphadenectomy was performed. Tumor was confirmed as LN metastasis from HCC by excisional histopathological examination. Adjuvant chemotherapy and radiotherapy were followed.
肝细胞癌(HCC)的肝外复发一直被认为不适于手术切除,因为该疾病被认为已广泛扩散。然而,小肝癌孤立性局部淋巴结复发的报道很少,且合适的治疗方式尚不确定。在此,我们报告一例60岁女性小肝癌患者,在原发性肝癌完全切除后出现晚期淋巴结转移。通过肝段切除术(Ⅷ段)完整切除了一个2厘米大小的肝脏肿块。八个月后,CT和PET扫描显示一个4.5厘米大小的门腔淋巴结(LN)。此外,全身PET/CT扫描强烈提示为孤立性肿瘤复发。遂进行了根治性淋巴结清扫术。切除的组织病理学检查证实肿瘤为HCC的LN转移。随后进行了辅助化疗和放疗。