Hashimoto Kazuhiko, Wakasa Tomoko, Kawasaki Toshihiko, Tsujimoto Tomoyuki, Gakuhara Atsushi, Tomihara Hideo, Fukuda Shuichi, Ohta Katsuya, Kitani Kotaro, Ishikawa Hajime, Hida Jinichi, Ohta Yoshio, Yukawa Masao, Inoue Masatoshi
Dept. of Surgery, Kindai University Nara Hospital.
Gan To Kagaku Ryoho. 2020 Dec;47(13):1893-1895.
A 69-year-old woman with a hepatocellular carcinoma(HCC)was followed-up for type B chronic hepatitis and underwent partial hepatectomy(S6)at our hospital. Afterwards, she underwent radiofrequency ablation(RFA)therapy twice because of intrahepatic recurrence. Seven months after the first hepatectomy, a left adrenalectomy was performed for a left adrenal metastasis. Seventeen months after the first hepatectomy, a splenectomy was performed for a splenic metastasis. Forty-three months after the first hepatectomy, a second hepatectomy was performed for intrahepatic recurrence, and a right adrenalectomy was performed for an adrenal metastasis. Sixty-eight months after the first hepatectomy, an abdominal CT revealed a growing solitary lesion in the ascending colon, which was diagnosed as a peritoneal metastasis. The peritoneal dissemination was removed because there were no other extrahepatic or intrahepatic recurrences. Histologically, the resected specimen was diagnosed as a peritoneal metastasis from a HCC. The patient survived, and there were no recurrences for 6 months after the operation. We report this case of a peritoneal metastasis from a HCC after surgery with a review of the literature.
一名69岁的肝细胞癌(HCC)女性患者因慢性乙型肝炎接受随访,并在我院接受了部分肝切除术(S6)。术后,由于肝内复发,她接受了两次射频消融(RFA)治疗。首次肝切除术后7个月,因左肾上腺转移行左肾上腺切除术。首次肝切除术后17个月,因脾转移行脾切除术。首次肝切除术后43个月,因肝内复发行第二次肝切除术,并因肾上腺转移行右肾上腺切除术。首次肝切除术后68个月,腹部CT显示升结肠有一个不断增大的孤立性病变,诊断为腹膜转移。由于没有其他肝外或肝内复发,故切除了腹膜播散灶。组织学检查显示,切除标本诊断为HCC腹膜转移。患者存活,术后6个月无复发。我们报告了这例HCC术后腹膜转移的病例,并对文献进行了回顾。