Study on Autopsy Cases of Hepatocellular Carcinoma

Saiho Ko, Takashi Nishiwada, Syusaku Yoshikawa, Masami Yagi, Yoshiyuki Nakajima*, Hiroshige Nakano*

Department of Surgery, Nara Prefectural Mimuro Hospital
*First Department of Surgery, Nara Medical University

Intrahepatic and extrahepatic spread of hepatocellular carcinoma was investigated in 20 autopsy cases. Intrahepatic spread, both vascular invasion and intrahepatic metastasis, was negative or minimal in sigle nodular type tumors, and severe in other types of tumors. Metastatic lymph node lesions were N0 in 8 cases and N3 in 12 cases. Distant organ metastasis was found mainly in the lung (11 cases) and adrenal gland (6 cases). All 4 patients with no distant organ metastasis had single nodular type tumors, and died of severe liver cirrhosis. Tumor stage classification (TMN) of the single nodular type tumors revealed 1 case of stage 1, 1 cases of stage 3, and 2 cases of stage 4A. All cases of other types of tumors were stage 4B. Preautopsy diagnosis of extrahepatic tumor spread presents serious problems. It may cause the wrong choice of therapeutic modality. Hepatic hilar and pancreaticoduodenal lymph nodes should be dissected for radical resection of hepatocellular carcinoma. Liver transplantation could be considered for a single nodular type tumor with severe liver cirrhosis.

Key words
autopsy cases of hepatocellular carcinoma, tumor spread, lymph node metastasis, indication for liver transplantation

Reprint requests
Saiho Ko First Department of Surgery, Nara Medical University
840 Shijocho, Kashihara, 634 JAPAN

Accepted
March 11, 1992

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