Shen Yonghua, Nie Ling, Yao Yuling, Yuan LiQing, Liu Zhenqing, Lv Ying
Department of Gastroenterology, The Affiliated Drum Tower Hospital of Nanjing University, Medical School.
Department of Pathology, The Affiliated Drum Tower Hospital of Nanjing University, Medical School, Nanjing, China.
Medicine (Baltimore). 2019 Jan;98(3):e13770. doi: 10.1097/MD.0000000000013770.
Cancer recurrence and metastasis after liver transplantation (LT) is common in some hepatocellular carcinoma (HCC) patients. The most common sites of extrahepatic metastases are lung, regional lymph node, adrenal gland, and bone. To our knowledge, HCC metastasis to the seminal vesicle after LT has not been reported in the literature.
A 56-year-old Asian man presented at hospital with a 9-year history of orthotopic LT because of HCC. The patient underwent surgery and radiotherapy for HCC metastasis to adrenal gland and 1 year later, chemotherapy for peritoneal metastasis. A few months later, the patient presented with computed tomography (CT) image showing masses in right lobe of liver, seminal vesicle, and space occupying mass between the spleen and stomach.
Combination of clinical and pathological features revealed the seminal vesicle mass as metastasis from HCC.
Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for liver and seminal vesicle lesions was performed and the postoperative pathology revealed malignancy. Thus, the patient underwent surgery and the diagnosis of seminal vesicle metastasis of HCC was confirmed by pathology and immunohistochemical analysis.
The patient died due to systemic failure.
Seminal vesicle metastasis from HCC after LT is rare and there is no consensus on its treatment. Further research into the pathogenesis and therapy of seminal vesicle from HCC after LT is needed to improve outcomes in the rare disease.
肝移植（LT）后癌症复发和转移在一些肝细胞癌（HCC）患者中很常见。肝外转移最常见的部位是肺、区域淋巴结、肾上腺和骨。据我们所知，文献中尚未报道LT后HCC转移至精囊。
一名56岁的亚洲男性因HCC接受原位LT已有9年，前来医院就诊。该患者因HCC转移至肾上腺接受了手术和放疗，1年后因腹膜转移接受了化疗。几个月后，患者的计算机断层扫描（CT）图像显示肝脏右叶、精囊有肿块，脾脏和胃之间有占位性肿块。
临床和病理特征相结合显示精囊肿块为HCC转移。
对肝脏和精囊病变进行了内镜超声引导下细针穿刺活检（EUS-FNA），术后病理显示为恶性。因此，患者接受了手术，病理和免疫组化分析证实了HCC精囊转移的诊断。
患者因全身衰竭死亡。
LT后HCC转移至精囊罕见，其治疗尚无共识。需要进一步研究LT后HCC精囊转移的发病机制和治疗方法，以改善这种罕见疾病的治疗效果。
