混合型肝癌の2切除例

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  • TWO RESECTABLE CASES OF COMBINED HEPATOCELLULAR AND CHOLANGIOCARCINOMA

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We encountered two resectable cases of combined hepatocellular and cholangiocarcinoma (CHC). Case I: A 55-year-old man with the SOL 6-cm in size, located in S5 of the liver and HCV-antibody positive. Although the SOL was suspected of being CHC based on the results of various examinations, a preoperative biopsy specimen was diagnosed as hepatocellular carcinoma. We resected S4, S5 and S8 and dissected out No 12 lymph nodes. Histologically tumor was CHC (mixed type) with metastasis to lymph node 12c. Six months later the patient died of recurrence in the remnant liver and lymph node metastases. Case II: A 52-year-old man with the two SOLs, 4cm and 1.5cm in diameter located in S8 of the liver and HCV-antibody positive. The tumors were suspected of being HCC with a satellite nodule, and we therefore resected S8. Histologically, the main tumor was HCC but the “satellite nodule” was CHC (mixed type). It is generally very difficult to diagnose CHC preoperatively. We conclude that if preoperative examinations and/or intraoperative findings indicate this entity, wide hepatic resection with lymph node dissection can be recommended within the limits of liver function.

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