Brain metastasis from hepatocellular carcinoma after radical hepatectomy.
Brain metastasis from hepatocellular carcinoma (HCC) is a rare, yet perplexing problem in patients with cancer. We report on 5 patients with metastasis of HCC to the brain after radical hepatectomy. Intrahepatic recurrence occurred in 3 patients, and distant metastasis to sites other than the brain was observed in 3 patients (lung, 2; bone, 1). The symptoms for brain metastasis included headache, hemiparesis, and vomiting. Hemorrhage was found in 4 of 5 patients. All patients had a single nodular lesion in the brain. The alpha-fetoprotein levels were more than 10,000 ng/ml in 4 patients. Two patients underwent surgical resection, 1 received cranial irradiation, and 2 were administered corticosteroids. The interval between diagnosis of the primary cancer and detection of brain metastasis ranged from 2 to 54 months. The mean survival period was only 3 months after diagnosis of brain metastasis. All 5 patients died of neurologic causes. Because no effective treatment for brain metastasis from HCC is available, further study is needed.
Asahara
T
T
Department of Surgery II, Hiroshima University School of Medicine, Japan.
Yano
M
M
Fukuda
S
S
Fukuda
T
T
Nakahara
H
H
Katayama
K
K
Itamoto
T
T
Dohi
K
K
Nakanishi
T
T
Kitamoto
M
M
Azuma
K
K
Ito
K
K
Moriwaki
K
K
Yuge
O
O
Shimamoto
F
F
D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000556:secondary; D001932:Brain Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000628:therapy; D006528:Carcinoma, Hepatocellular / Q000556:secondary* / Q000601:surgery / Q000628:therapy; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D012008:Recurrence