A Case of Sclerosing Hepatic Carcinoma with a Solitary Abdominal Lymph Node Metastasis Developing 9 Years after Hepatectomy

Nobusada Koike, Shuji Suzuki, Masayuki Imazato, Seiichi Tanaka, Tuneo Hayashi, Mamoru Suzuki, Fujio Hanyu and Masakazu Yamamoto^*

Department of Surgery, Hachioji Digestive Disease Hospital, ^*Department of Surgery, Institute of Gasteoenterology, Tokyo Woman's Medical University

A 59-year-old man diagnosed with hepatocellular carcinoma, lateral hepatectomy in July 1991 to excise a 4×3 cm nodular, found to be sclerosing hepatic carcinoma, EdI+II, IV, fc (-), sf (-), vp0, vv0, b1, tw (-), im1, z1. In ambulatory observation since 1996, his serum AFP was found to be elevated. Abdominal computed tomography (CT) in April 2000 showed a peritoneal lymphadenopathy and angiography showed dark tumor staining extending from the left gastric artery. The patient was free of recurrence from the residual liver or metastatic foci in other organs. Under a diagnosis of lymph node metastasis of liver cancer, the patient underwent surgery in July 2000. This case remonstrates hepatocellular carcinoma treated by hepatectomy with no recurrence in residual liver tissue but resulting in solitary lymphatic metastasis 9 years later that was excised. We also present a review of the literature.

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

Reprint requests
Nobusada Koike Department of Surgery, Hachioji Digestive Disease Hospital 3-18-1 Koyasu, Hachioji, 192-0904 JAPAN

Accepted
February 27, 2002

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