title: [A surgical case of solitary lymph node metastasis of hepatocellular carcinoma after nonsurgical treatment].
abstract: A 66-year-old man with multiple hepatocellular carcinomas(HCCs) underwent transcatheter arterial chemoembolization(TACE) twice and radiofrequency ablation(RFA) twice at another hospital in June 2009. In November 2010, abdominal computed tomography(CT) revealed a solitary lymph node metastasis( 23 mm in diameter) in the hepatoduodenal ligament, after which he was admitted to our hospital in December 2010. In February 2011, ethoxybenzyl diethylenetriamine pentaceric acid-enhanced magnetic resonance imaging (EOB-MRI) showed revealed a growing solitary lymph node metastasis(33 mm in diameter) and good control of the intrahepatic lesion. Positron emission tomography(PET)-CT confirmed the solitary lymph node metastasis without any other extrahepatic recurrence. We performed lymph node resection in March 2011 because of good control of the intrahepatic lesion and the lack of extrahepatic recurrence. He was discharged from our hospital 11 days after surgery with a good postoperative course. Histologically, the tumor was diagnosed as a lymph node metastasis of poorly differentiated HCC. Subsequent abdominal CT in January 2012 revealed multiple recurrent lesions, and he underwent TACE therapy in February 2012. Currently, the patient is alive 1 year 3 months after lymph node resection without any other extrahepatic recurrence.
authors.affiliation: Dept. of Surgery, Yao Municipal Hospital, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Hashimoto
authors.forename: Yo
authors.initials: Y
authors.lastname: Sasaki
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Yokoyama
authors.forename: Reishi
authors.initials: R
authors.lastname: Toshiyama
authors.forename: Atsushi
authors.initials: A
authors.lastname: Naito
authors.forename: Shuichi
authors.initials: S
authors.lastname: Fukuda
authors.forename: Shinji
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Tokuoka
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Ide
authors.forename: Jin
authors.initials: J
authors.lastname: Matsuyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Morimoto
authors.forename: Yukio
authors.initials: Y
authors.lastname: Fukushima
authors.forename: Takashi
authors.initials: T
authors.lastname: Nomura
authors.forename: Ken
authors.initials: K
authors.lastname: Kodama
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Yoshida
authors.forename: Ikue
authors.initials: I
authors.lastname: Shiba
authors.forename: Masashi
authors.initials: M
authors.lastname: Takeda
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy*; D008207:Lymphatic Metastasis; D008297:Male