Second Department of Surgery, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
Surg Today. 2010 Apr;40(4):360-4. doi: 10.1007/s00595-009-4035-4. Epub 2010 Mar 26.
Fibrolamellar hepatocellular carcinoma (FL-HCC) is an uncommon clinicopathological variant of hepatocellular carcinoma (HCC). The etiology of FL-HCC is unknown, but FL-HCC is not associated with hepatic viruses or alcohol. Hepatocellular carcinoma usually occurs in cases of chronic hepatitis or cirrhosis, whereas FL-HCC predominantly occurs in a normal liver and in younger adults. Fibrolamellar HCC shows relatively slow growth, and late recurrence is common. Repeated resections for recurrences should be considered not only because there is a lack of other effective treatment options but also because FL-HCC shows a relatively better prognosis after a resection in comparison to common HCC. This report presents a case of a rare mediastinal metastasis from FL-HCC in a patient who had undergone a previous resection for retroperitoneal metastasis after the initial hepatic operation. This is the second report of the same case. This patient also had a mediastinal neurogenic tumor, and these mediastinal tumors were concurrently resected.
纤维板层肝细胞癌（FL-HCC）是肝细胞癌（HCC）的一种罕见临床病理变异型。FL-HCC 的病因尚不清楚，但与肝病毒或酒精无关。肝细胞癌通常发生在慢性肝炎或肝硬化的情况下，而 FL-HCC 主要发生在正常肝脏和年轻成年人中。纤维板层 HCC 生长相对缓慢，晚期复发较为常见。应考虑对复发进行反复切除，不仅因为缺乏其他有效治疗选择，还因为与常见 HCC 相比，FL-HCC 在切除后显示出相对更好的预后。本报告介绍了一例罕见的源自 FL-HCC 的纵隔转移病例，该患者在最初的肝手术后曾行腹膜后转移的切除术。这是同一病例的第二次报告。该患者还患有纵隔神经源性肿瘤，这些纵隔肿瘤被同时切除。
