Nakagawa K, Nakahara K, Ohno K, Matsumura A, Kawashima Y
Kyobu Geka. 1989 Sep;42(10):857-60.
A 54 year-old man, who had been operated for hepatocellular carcinoma 43 months before, complained of frequent cough. He had widening of mediastinal shadow on chest X-ray film and high level of alpha-fetoprotein (197 ng/ml). Under the diagnosis of metastasis to mediastinum of hepatocellular carcinoma, lymph node dissection was performed and disclosed large metastatic tumors in subcarinal, right tracheobronchial and left hilar lymph nodes. After operation, frequent cough disappeared and alpha-fetoprotein level fell to 38 ng/ml. Metastasis to the mediastinum without lung metastasis of hepatocellular carcinoma was recognized only 2.6% in non-operated cases in annual of pathological autopsy cases in Japan 1980 and 4 case reports were found in literature with large metastatic mass shadow in mediastinum of hepatocellular carcinoma.
一名54岁男性，43个月前曾因肝细胞癌接受手术，现主诉频繁咳嗽。胸部X线片显示纵隔阴影增宽，甲胎蛋白水平升高（197 ng/ml）。在诊断为肝细胞癌纵隔转移后，进行了淋巴结清扫，发现隆突下、右气管支气管和左肺门淋巴结有大量转移瘤。术后，频繁咳嗽消失，甲胎蛋白水平降至38 ng/ml。在1980年日本年度病理尸检病例中，未手术的病例中肝细胞癌纵隔转移而无肺转移的情况仅占2.6%，文献中发现有4例报告肝细胞癌纵隔有大的转移肿块阴影。
