A Case of Splenic Metastasis from Hepatocellular Carcinoma

Yukihito Niimi, Satoru Akashi, Mitsuo Nagao, Saiho Ko, Junji Okayama and Yoshiyuki Nakajima

Department of Surgery, Nara Medical University

A 55-year-old man who had was undergone extended right lobectomy for a huge hepatocellular carcinoma (HCC) in February 1996 then underwent TAE to manage HCC recurrence twice and partial resection of the lung for metastasis twice in 3 years. A splenic tumor 2.5 cm in diameter detected in computed tomography in November 2001 grew 5 cm in diameter in 2 months. In laparotomy on January 31, 2002, under a diagnosis of splenic metastasis from HCC, we located the tumor in the upper pole of the spleen, firmly attached to the diaphragm and lateral lobe of the liver without peritoneal dissemination. We conducted splenectomy and partial resection of the diaphragm and liver. Pathologically, the tumor was identical to HCC histology and covered with a splenic capsule. Taken together, we diagnosed this case as splenic metastasis from HCC-a rare with a poor prognosis due to frequent metastasis to other organs. Treatment options are resection, chemotherapy, and TAE. In cases with no other lesion, such as in this case, surgical resection should yield a good prognosis.

Key words
hepatocelluler carcinoma, spleen, metastasis

Reprint requests
Yukihito Niimi Department of Surgery, Saiseikai Nara Hospital
4-643 Hachijo, Nara, 630-8146 JAPAN

Accepted
November 30, 2005

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