Solitary Extrahepatic Intraabdominal Metastasis from Hepatocellular Carcinoma after Liver Transplantation
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
A liver transplantation is a treatment option in selected patients with hepatocellular carcinoma (HCC). Despite the adequate selection of candidates, recurrences of HCC may still develop. Solitary extrahepatic metastasis from HCC after a liver transplantation is rare. Here we report two cases of HCC demonstrated extrahepatic recurrence to the adrenal gland and spleen, respectively, within one year after a liver transplantation. Since the treatment of solitary extrahepatic metastasis from HCC after a liver transplantation is not standardized, surgical resection was performed. In the case of HCC adrenal metastasis, innumerable intrahepatic metastases were found two months after the adrenalectomy. And 16 months after adrenalectomy,the patient expired due to tumor progression and hepatic failure. In the case of HCC splenic metastasis, postoperative radiation therapy was performed. However, two recurrent HCC nodules were found 15 months after the splenectomy and received transarterial chemoembolization (TACE). And 29 month after the splenectomy, the patient also expired as same causes of former patient.
Abstract
A liver transplantation is a treatment option in selected patients with hepatocellular carcinoma (HCC). Despite the adequate selection of candidates, recurrences of HCC may still develop. Solitary extrahepatic metastasis from HCC after a liver transplantation is rare. Here we report two cases of HCC demonstrated extrahepatic recurrence to the adrenal gland and spleen, respectively, within one year after a liver transplantation. Since the treatment of solitary extrahepatic metastasis from HCC after a liver transplantation is not standardized, surgical resection was performed. In the case of HCC adrenal metastasis, innumerable intrahepatic metastases were found two months after the adrenalectomy. And 16 months after adrenalectomy,the patient expired due to tumor progression and hepatic failure. In the case of HCC splenic metastasis, postoperative radiation therapy was performed. However, two recurrent HCC nodules were found 15 months after the splenectomy and received transarterial chemoembolization (TACE). And 29 month after the splenectomy, the patient also expired as same causes of former patient.
참고문헌 (15)
- Mazzaferro V, "Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis", N Engl J Med, 334, pp.693~699 (1996)
- Yao FY, "Liver transplantation for hepatocellular carcinoma: expansion of the tumor size limits does not adversely impact survival", Hepatology, 33, pp.1394~1403 (2001)
- Schwartz M, "Liver transplantation for hepatocellular carcinoma", Gastroenterology, 127(5 Suppl 1), pp.S268~S276 (2004)
- Katyal S, "Extrahepatic metastases of hepatocellular carcinoma", Radiology, 216, pp.698~703 (2000)
- Castroagudín JF, "Bilateral adrenal metastases from hepatocellular carcinoma after liver transplantation", Hepatogastroenterology, 49, pp.249~251 (2002)
- Nakashima T, "Pathology of hepatocellular carcinoma in Japan. 232 Consecutive cases autopsied in ten years", Cancer, 51, pp.863~877 (1983)
- Hu RH, "Feasibility of salvage liver transplantation for patients with recurrent hepatocellular carcinoma", Clin Transplant, 19, pp.175~180 (2005)
- Llovet J, "Resection and liver transplantation for hepatocellular carcinoma", Semin Liver Dis, 25, pp.181~200 (2005)
- Pérez-Saborido B, "Tumor recurrence after liver transplantation for hepatocellular carcinoma: recurrence pathway and prognostic factors", Transplant Proc, 통권 : 39, pp.2304~2307 (2007)
- Vivarelli M, "Analysis of risk factors for tumor recurrence after liver transplantation for hepatocellular carcinoma: key role of immunosuppression", Liver Transpl, 11, pp.497~503 (2005)
- Escartin A, "Recurrence of hepatocellular carcinoma after liver transplantation", Transplant Proc, 통권 : 39, pp.2308~2310 (2007)
- Poon RT, "Aggressive management of patients with extrahepatic and intrahepatic recurrences of hepatocellular carcinoma by combined resection and locoregional therapy", J Am Coll Surg, 195, pp.311~318 (2002)
- 성진실, "Challenge and Hope in Radiotherapy of Hepatocellular Carcinoma", Yonsei Medical Journal, 50(5), pp.601~612 (2009), 연세대학교의과대학
- Park JS, "What is the best treatment modality for adrenal metastasis from hepatocellular carcinoma?", JOURNAL OF SURGICAL ONCOLOGY, 96, pp.32~36 (2007), WILEY-LISS
- Lee SS, "Splenectomy for splenic metastases: a changing clinical spectrum", Am Surg, 66, pp.837~840 (2000)