A Case of Solitary Para-Aortic Lymph Node Metastasis of Hepatocellular Carcinoma Treated with Single Resection

Hiromichi Yamai, Takahiro Yoshida, Jyuniti Seike, Jyunko Honda, Takanori Miyoshi, Hirokazu Takechi, Yasuhiro Yuasa, Atsushi Umemoto, Akira Tangoku and Mitsuo Shimada

Department of Surgery, University of Tokushima

We report a case of the which was treated with TAE, RFA and surgery. In 2003, a 60-year-old man followed up for chronic hepatitis C and admitted for examination of intrahepatic lesions detected in urtrasonography was found in abdominal computed tomography (CT) to have two intrahepatic masses of about 4 cm and 4.5 cm and a solitary swollen 2.8 cm lymph node to the right of the aorta. We diagnosed the intrahepatic lesions as hepatocellular carcinoma (HCC), but we could not diagnose the paraaortic lesion as a metastatic lymph node. We treated the hepatic lesion with TAE and RFA, and followed up the paraaortic mass, which became enlarged two months later. We resected the lymph node. The postoperative course was uneventful and the patient was discharged. Serum AFP decreased from a preoperative 2,685 ng/ml to a postoperative 3 ng/ml. Two years later, neither intrahepatic recurrence nor the presence of the metastatic lymph node was seen.

Key words
solitary lymph node metastasis, hepatocellular carcinoma, paraaortic lymph node metastasis

Reprint requests
Hiromichi Yamai Department of Oncological and Regenerative Surgery, Institute of Health Bioscience, University of Tokushima
3-18-15 Kuramotocho, Tokushima, 770-8503 JAPAN

Accepted
September 26, 2007

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