A Case Report of Lymph Node Metastasis of Hepatocellular Carcinoma after Interferon Therapy with Long Survival by Lymph Node Resection

Satoshi Katagiri, Masakazu Yamamoto, Takehito Otsubo, Hideo Katsuragawa, Kenji Yoshitoshi, Mie Hamano, Shunichi Ariizumi and Ken Takasaki

Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University

The patient was a 60-year-old woman with chronic hepatitis C after interferon therapy with complete response. On October 16,1995, resection of segments 4 and 8 of the liver was performed for a 3 cm hepatic tumor identified in segments 4 and 8. Histopathologically, the hepatic lesion showed moderately differentiated hepatocellular carcinoma (HCC) fc (+) fc-inf (+) vp0 vv0 b0 tw (-) im0 and concomitant chronic hepatitis. Abdominal ultrasonography performed 5 months postoperatively disclosed a low echoic mass posterior to the near of the pancreas head. Abdominal computed tomography revealed a low density tumor at the level of the pancreas head. Angiography revealed a slightly hypervascular lesion at the gastroduodenal artery. We diagnosed lymph node metastasis of HCC and performed lymph node resection. Histopathologically, the lymph node showed a poorly differentiated HCC with solid growth. Six years later, no intrahepatic recurrence or lymph node metastasis has been observed over the entire course. This case represents an extremely rare presentation of metastatic HCC.

Key words
hepatocellular carcinoma, lymph node metastasis, interferon therapy

Reprint requests
Katagiri Satoshi Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University 8-1 Kawada-cho, Shinjyuku-ku, Tokyo, 162-8666 JAPAN

Accepted
May 27, 2003

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