Dissection of Para-aortic Lymph Node Metastasis after Surgery for Hepatocellular Carcinoma -Report of a Case

Shintaro Akamoto, Kunihiko Izuishi, Shinichi Yachida, Keiichi Okano, Fuminori Goda, Hisao Wakabayashi, Hisashi Usuki and Hajime Maeta

First Department of Surgery, Faculty of Medicine, Kagawa University

We report surgery for paraaortic lymph node recurrence after surgery for hepatocellular carcinoma. The 77-year-old woman had a history of partial hepatic resection (S8) of the liver for hepatocellular carcinoma in 2001. We dissected lymph nodes No. 12 and No. 13, and metastases was detected in No. 12. In 2003, paraaortic lymphadenopathy was found by computed tomography. The paraaortic lymph node was dissected and diagnosed pathologically as solitary recurrence of hepatocellular carcinoma. 22 months after surgery, multiple liver metastasis were detected. She remained alive for 2 years after the second operation. Lymph node metastasis of hepatocellular carcinoma is not uncommon, as demonstrated by its incidence of 28.2% in all autopsy cases in the Japanese literature, but it accounts for only 1.6% of metastases in hepatectomy cases. Solitary lymph node metastasis of hepatocellular carcinoma is usually found at the hepatoduodenal ligament or retropancreatic area.

Key words
hepatocellular carcinoma, paraaortic lymph node metastasis

Reprint requests
Shintaro Akamoto First Department of Surgery, Faculty of Medicine, Kagawa University
1750-1 Ikenobe, Miki, Kita, 761-0793 JAPAN

Accepted
October 19, 2005

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