Department of Surgery, Korea University College of Medicine, Seoul, Korea.
Yonsei Med J. 2011 Jan;52(1):199-203. doi: 10.3349/ymj.2011.52.1.199.
A liver transplantation is a treatment option in selected patients with hepatocellular carcinoma (HCC). Despite the adequate selection of candidates, recurrences of HCC may still develop. Solitary extrahepatic metastasis from HCC after a liver transplantation is rare. Here we report two cases of HCC demonstrated extrahepatic recurrence to the adrenal gland and spleen, respectively, within one year after a liver transplantation. Since the treatment of solitary extrahepatic metastasis from HCC after a liver transplantation is not standardized, surgical resection was performed. In the case of HCC adrenal metastasis, innumerable intrahepatic metastases were found two months after the adrenalectomy. And 16 months after adrenalectomy, the patient expired due to tumor progression and hepatic failure. In the case of HCC splenic metastasis, postoperative radiation therapy was performed. However, two recurrent HCC nodules were found 15 months after the splenectomy and received transarterial chemoembolization (TACE). And 29 month after the splenectomy, the patient also expired as same causes of former patient.
肝移植是治疗肝细胞癌（HCC）的一种选择。尽管对患者进行了充分的选择，但 HCC 仍可能复发。肝移植后 HCC 单发肝外转移较为罕见。在此，我们报告两例肝移植后 1 年内分别发生 HCC 肾上腺和脾脏外肝外复发的病例。由于肝移植后 HCC 单发肝外转移的治疗尚未标准化，因此进行了手术切除。在 HCC 肾上腺转移的情况下，肾上腺切除术后两个月发现了无数的肝内转移。肾上腺切除术后 16 个月，患者因肿瘤进展和肝功能衰竭而死亡。在 HCC 脾转移的情况下，进行了术后放射治疗。然而，脾切除术后 15 个月发现了 2 个复发性 HCC 结节，并接受了经动脉化疗栓塞（TACE）。脾切除术后 29 个月，该患者也因与前一位患者相同的原因死亡。
