首页|Surgical resection of a solitary para-aortic lymph node metastasis from hepatocellular carcinoma
Surgical resection of a solitary para-aortic lymph node metastasis from hepatocellular carcinoma
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Lymph node (LN) metastases from hepatocellular carcinoma (HCC) are considered uncommon.We describe the surgical resection of a solitary para-aortic LN metastasis from HCC.A 65-year-old Japanese man with B-type liver cirrhosis was admitted for the evaluation of a liver tumor.He had already undergone radiofrequency ablation,transcatheter arterial chemoemboliza tion,and percutaneous ethanol injection therapy for HCC.Despite treatment,viable regions remained in segments 4 and 8.We performed a right paramedian sectionectomy with partial resection of the left paramedian section of the liver.Six months later,serum concentrations of alpha-fetoprotein (189 ng/mL) and PIVKA-2 (507 mAU/mL) increased.Enhanced computed tomography of the abdomen revealed a tumor (20 mm in diameter) on the right side of the abdominal aorta.Fluorine-18 fluorodeoxyglucose positron emission tomography revealed an increased standard uptake value.There was no evidence of recurrence in other regions.Esophagogastroduodenoscopy and colonoscopy revealed no malignant tumor in the gastrointestinal tract.Para-aortic LN metastasis from HCC was thus diagnosed.We performed lymphadenectomy.Histopathological examination revealed that the tumor was largely necrotic,with poorly differentiated HCC on its surface,which confirmed the suspected diagnosis.After 6 mo tumor marker levels were normal,with no evidence of recurrence.Our experience suggests that a solitary para-aortic LN metastasis from HCC can be treated surgically.
NETL
NSTL
万方数据
维普
