Maruo H, Kirihara M, Hasegawa K, Kawai S, Tominaga S, Ichikawa T, Kume S
Dept. of Surgery, Toshiba General Hospital.
Gan To Kagaku Ryoho. 1998 Jul;25(9):1416-8.
A 76-year-old man was totally gastrectomized in June, 1996 for advanced gastric cancer. In February, 1997, multiple liver metastases were found by abdominal CT scan, and hepatic arterial infusion chemotherapy was started with 5-FU, EPI and MMC by an implantable reservoir indwelled via the left subclavian artery. This treatment was judged to have led to a partial response because reduced focus size of the liver metastasis was revealed by CT scan and levels of tumor markers decreased significantly. However, metastatic foci were found in the skin of the superior lip and the orbit in December 1997. He was treated with a variety of therapies, but died in January, 1998. Many cases with metastatic hepatic cancer have a poor prognosis because of the appearance of extrahepatic lesions in spite of the fact that a partial response can be obtained by hepatic arterial infusion chemotherapy. The present case was unique since extrahepatic lesions appeared at very rare sites such as the superior lip and the orbit.
一名76岁男性于1996年6月因进展期胃癌接受了全胃切除术。1997年2月，腹部CT扫描发现多处肝转移，遂通过经左锁骨下动脉留置的植入式储液器开始用5-氟尿嘧啶、表柔比星和丝裂霉素进行肝动脉灌注化疗。由于CT扫描显示肝转移灶大小缩小且肿瘤标志物水平显著下降，该治疗被判定为部分缓解。然而，1997年12月在上唇皮肤和眼眶发现了转移灶。他接受了多种治疗，但于1998年1月去世。尽管肝动脉灌注化疗可获得部分缓解，但许多转移性肝癌病例因肝外病变的出现而预后较差。本病例独特之处在于肝外病变出现在非常罕见的部位，如上唇和眼眶。
