Hashimoto Yasuji, Kishimoto Tomoya, Nagano Shinnosuke, Murotani Masatoshi, Shigetsu Kaichi, Yoneda Naoki, Morioka Tomomi, Kidogami Shinya, Mokutani Yukako, Hirose Hajime, Yoshioka Shinichi, Kawata Junji, Takeda Masashi, Tamura Shigeyuki, Sasaki Yo
Dept. of Surgery, Yao Municipal Hospital.
Gan To Kagaku Ryoho. 2020 Dec;47(13):2284-2286.
A 76-year-old man had undergone right lobectomy after transcatheter arterial chemoembolization(TACE)for hepatocellular carcinoma(HCC)in segment 5/6 of the liver. He had undergone TACE for intrahepatic recurrence in segment 1 eight months after the operation. Abdominal CT revealed intrahepatic recurrence in segment 2 and segment 3 and a hepatic portal lymph node swelling 13 months after the operation, he underwent TACE and radiofrequency ablation for intrahepatic lesions. There was neither intrahepatic recurrences nor new extrahepatic lesions, and the hepatic portal lymph node resection was performed. He was discharged on postoperative day 8, and there has been no subsequent recurrence over 42 months after initial treatment. The lymph node metastasis of HCC is rare and systemic chemotherapy such as molecular targeted argent is the standard treatment, but its prognosis is poor. When a patient has a resectable metastasis with controlled intrahepatic lesions, lymph node resection appears to be an effective option.
一名76岁男性因肝脏第5/6段肝细胞癌（HCC）在经动脉化疗栓塞术（TACE）后接受了右叶切除术。术后8个月，他因肝内第1段复发接受了TACE治疗。术后13个月，腹部CT显示肝内第2段和第3段复发以及肝门淋巴结肿大，他接受了针对肝内病变的TACE和射频消融治疗。既没有肝内复发也没有新的肝外病变，于是进行了肝门淋巴结切除术。他术后第8天出院，初始治疗后42个月内未再复发。HCC的淋巴结转移罕见，分子靶向药物等全身化疗是标准治疗方法，但其预后较差。当患者肝内病变得到控制且转移灶可切除时，淋巴结切除术似乎是一种有效的选择。
