Hepatocellular carcinoma with recurrent extrahepatic metastases: a case of long-term survival
Abstract
A 61-year-old man had been followed-up for chronic hepatitis since 1982. In 1995, he was diagnosed with primary hepatocellular carcinoma (HCC) and liver cirrhosis and was admitted to our hospital with a Child-Pugh score of 6 (class A). A right hepatic arteriogram revealed two tumors: one measured 23×21 mm in size and was located in segment 6 of the liver, while the other measured 16×14 mm in size and was located in segment 4. The tumors were treated with transarterial chemoembolization (TACE) and percutaneous ethanol injection (PEI). In 1996, a new HCC in segment 8, a recurrent HCC in segment 4, and a right adrenal metastasis were detected, all of which were treated with TACE. In 1997, the right adrenal metastasis recurred, and TACE was performed again. In 1999, TACE was used to treat metastases in a lymph node along the lesser curvature of the stomach and a lymph node along the left gastric artery. In 2002, a recurrent metastatic lesion developed in the lymph node along the lesser curvature of the stomach and was subjected to TACE. In 2005, a recurrent HCC lesion, measuring 18 mm in diameter, was detected in segment 4, and radiofrequency ablation (RFA) was performed. The patient experienced repeated HCC recurrences, as well as adrenal and lymph node metastases, but received multidisciplinary treatment, including TACE, PEI, and RFA, and survived for 12 years.
References
Uka K, Aikata H, Takaki S, Shirakawa H, Jeong SC, Yamashina K, Hiramatsu A, Komada H, Takahashi S, Chayama K. Clinical features and prognosis of patients with extrahepatic metastases from hepatocellular carcinoma. World J Gastroenterol 2007; 13(3): 414-420
Natsuizaka M, Omura T, Akaike T, Kuwata Y, Yamazaki K, Sato T, Karino Y, Toyota J, Suga T, Asaka M. Clinical features of hepatocellular carcinoma with extrahepatic metastases. J Gastroenterol Hepatol 2005; 20: 1781-1787
Jung SM, Jang JW, You CR, Yoo SH, Kwon JH, Bae SH, Choi JY, Yoon SK, Chung KW, Kay CS, Jung HS. Role of intrahepatic tumor control in the prognosis of patients with hepatocellular carcinoma and extrahepatic metastases. J Gastroenterol Hepatol 2012; 27:684-689
Kanda M, Tateishi R, Yoshida H, Sato T, Masuzaki R, Ohki T, Imamura J, Goto T, Yoshida H, Hamamura K, Obi S, Kanai F, Shiina S, Omata M. Extrahepatic metastasis of hepatocellular carcinoma: incidence and risk factors. Liver Int 2008;28: 1256-63
Uenishi T, Hirohashi K, Shuto T, Kubo S, Tanaka H, Sakata C, Ikebe T, Kinoshita H. The Clinical significance of lymph node metastases in patients undergoing surgery for hepatocellular carcinoma. Surg Today 2000; 30: 892-895
Uehara K, Hasegawa H, Ogiso S, Sakamoto E, Ohira S, Igami T, Mori T. Skip lymph node metastases from a small hepatocellular carcinoma with difficulty in preoperative diagnosis. J Gastroenterol Hepatol 2003; 18: 345-349
Sun HC, Zhuang PY, Qin LX, Ye QH, Wang L, Ren N, Zhang JB, Qian YB, Lu L, Fan J, Tang ZY. Incidence and prognostic values of lymph node metastasis in operable hepatocellular carcinoma and evaluation of routine complete lymphadenectomy. J Surg Oncol. 2007; 96: 37-45
Hasegawa K, Makuuchi M, Kokudo N, Izumi N, Ichida T, Kudo M, Ku Y, Sakamoto M, Nakashima O, Matsui O, Matsuyama Y. Impact of histologically confirmed lymph node metastases on patient survival after surgical resection for hepatocellular carcinoma: report of a Japanese nationwide survey. Ann Surg 2014; 259: 166-170
Kobayashi S, Takahashi S, Kato Y, Gotohda N, Nakagohri T, Konishi M, Kinoshita T. surgical treatment of lymph node metastases from hepatocellular carcinoma. J Hepatobiliary Pancreat Sci 2011; 18: 559-566
Momoi H, Shimahara Y, Terajima H, Iimura Y, Yamamoto N, Yamamoto Y, Ikai I, Yamaoka Y. Management of adrenal metastasis from hepatocellular carcinoma. Surg Today 2002; 32: 1035-1041
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