Two Surgical Cases of Hepatocellular Carcinoma with Lymph Node Metastasis

Shunji Morita, Mitsukazu Gotoh, Hiroaki Nagano, Masato Sakon, Toshio Kanai, Koji Umeshita, Kenichi Wakasa¹⁾, Masami Sakurai¹⁾, Hironobu Nakamura²⁾, Chikazumi Kuroda²⁾, Morito Monden, Takesada Mori

Department of Surgery II, Osaka University Medical School
¹⁾Department of Pathology, Osaka City University Hospital
²⁾Department of Radiology, Osaka University Medical School

We experienced two surgical cases of hepatocellular carcinoma with lymph node metastasis, an uncommon condition in the field of surgical treatment. The first case was a 72-year-old man diagnosed as having hepatocellular carcinoma of about 3 cm in diameter in the anterior segment with portal thrombosis. As para-aortic lymph node swelling was found at the surgery, we performed right lobectomy of the liver with extirpation of the node. The diagnosis of metastasis of hepatocellular carcinoma was made by pathological examination. The patient died of gastro-intestinal bleeding 4 years after the operation. The second case is 55-year-old man diagnosed as having hepatocellular carcinoma of 9 cm in diameter in the lower posterior segment with metastasis to a few lymph nodes metastasis. We performed subsegmental hepatectomy with extirpation of all swollen lymph nodes. However, recurrence was found in the residual liver 3 months after the operation in this case. He died of cancer recurrence 5 months after the operation. From our cases and other reports, it was suggested that hepatic resection with extirpation of a metastatic lymph node might be curative, only when the number of lymph nodes is one in the case of hepatocellular carcinoma with lymph node metastasis.

Key words
hepatocellular carcinoma, lymph node metastasis of hepatocellular carcinoma, hepatic resection

Reprint requests
Morito Monden Department of Surgery II, Osaka University Medical School
1-1-50 Fukushima, Fukushima-ku, Osaka, 553 JAPAN

Accepted
May 11, 1993

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