title: [Surgical Resection for Mediastinal Lymph Node Metastasis of Combined Hepatocellular and Cholangiocarcinoma--A Case Report].
abstract: We report the case of a 77-year-old woman with mediastinal lymph node metastasis of combined hepatocellular and cholangiocarcinoma who was successfully treated with S8 segmentectomy and lymphadenectomy. A hepatic nodule was detected in segment 8 during follow-up computed tomography (CT) after left iliac arterial aneurysm repair. The patient was diagnosed with a hepatocellular carcinoma (HCC), and transcatheter arterial chemoembolization (TACE) was selected for HCC because of the patient's condition. The levels of tumor markers did not change after TACE was performed twice. Therefore, TACE treatment was considered to be ineffective for HCC, and the patient was admitted to our hospital for surgical resection. In addition to the primary lesion, a lymph node with a diameter of 20 mm was detected in the anterior mediastinum using CT and magnetic resonance imaging(MRI). We did not find any other metastases, and therefore, S8 segmentectomy and lymphadenectomy in the anterior mediastinum were performed. Recovery was uneventful, and the patient was discharged from the hospital on postoperative day 12. Based on histopathologic findings, combined hepatocellular and cholangiocarcinoma with mediastinal lymph node metastasis was confirmed. Levels of tumor markers normalized, and the patient survived without recurrence for 6 months.
authors.affiliation: Dept. of General Surgery, Graduate School of Medicine, Chiba University.
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Yoshida
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimizu
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ohtsuka
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kato
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Yoshitomi
authors.forename: Katsunori
authors.initials: K
authors.lastname: Furukawa
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Takayashiki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kuboki
authors.forename: Shigetsugu
authors.initials: S
authors.lastname: Takano
authors.forename: Daiki
authors.initials: D
authors.lastname: Okamura
authors.forename: Daisuke
authors.initials: D
authors.lastname: Suzuki
authors.forename: Nozomu
authors.initials: N
authors.lastname: Sakai
authors.forename: Shingo
authors.initials: S
authors.lastname: Kagawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nojima
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazaki
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000473:pathology* / Q000601:surgery; D006528:Carcinoma, Hepatocellular / Q000556:secondary* / Q000601:surgery; D018281:Cholangiocarcinoma / Q000556:secondary* / Q000601:surgery; D004621:Embolization, Therapeutic; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008482:Mediastinum / Q000473:pathology*