Pancreaticoduodenectomy for hepatic portal lymph node metastasis after hepatic resection for hepatocellular carcinoma: A clinical case report
| Autor: | Vu Duc Long, Tran Thu Huong, Pham Van Tuyen, Tran Que Son, Tran Hieu Hoc, Nguyen Toan Thang |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Hepatocellular carcinoma medicine.medical_treatment Case Report Metastasis Pancreaticoduodenectomy Gastroduodenal artery 03 medical and health sciences 0302 clinical medicine medicine.artery medicine Transcatheter arterial chemoembolization Lymph node Liver resection business.industry medicine.disease medicine.anatomical_structure Pancreatic head 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Surgery Radiology Hepatectomy Liver cancer business |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Introduction In 2018, Hepatocellular carcinoma (HCC) was predicted to be the sixth most commonly diagnosed cancer. Extra-hepatic metastasis due to HCC is a poor prognostic factor, depending on the stage of the disease. Presentation of case We report a case of a 52-years old male who had undergone Segment 5 (S5) hepatectomy for HCC of 4.7 × 2 cm. Transcatheter arterial chemoembolization (TACE) four times postoperatively was performed based on a preoperative diagnosis of a recurrent tumour at the S1. After 2 years, the solitary tumour (7.5 × 2.5 × 3.5 cm) is located behind the right lobe of the liver and the head of the pancreas. The tumour was abnormally supplied with blood from the superior mesenteric artery (SMA) and the gastroduodenal artery (GDA). The patient was underwent pancreaticoduodenectomy (PD) to remove a large tumour. Postoperative pathology and immunohistochemical staining showed metastatic HCC. There was no tumour recurrence after 6 months. Discussion The organs in the body that liver cancer cells most often spread to are the lungs (44%), the portal vein (35%), the hepatobiliary ganglion (27%), and a small number of cases of bone, eye socket, bronchus metastases. Otherwise, recurrence of lymph nodes (LNs) after hepatectomy for HCC is very rare. Conclusions HCC can metastasize to the hepatic pedicle LN after hepatectomy and maybe confused with recurrent liver tumours in the S1. Indications for PD are feasible for solitary metastatic at peri-pancreas. Pathology incorporating immunohistochemistry can determine the origin of metastases. Highlights • Recurrence of lymph nodes after hepatectomy due to HCC is very rare at only approximately 1% to 2.5%. • HCC can metastasize to the hepatic pedicle lymph node after hepatectomy and is easily confused with recurrent liver tumours in the S1 • Indications for pancreaticoduodenectomy are feasible for solitary metastatic at peri-pancreas |
| Databáze: | OpenAIRE |
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