肝細胞癌の胸膜転移の1例

Experience with Pleural Metastasis from Hepatocellular Carcinoma；Report of a Case

はじめに　肝細胞癌の肝外再発は肺，骨，リンパ節の順に多く，胸膜への転移再発は非常にまれである1，2）．われわれは，肝細胞癌の胸膜転移と判断された病巣に対して切除術を行った1例を経験したので報告する．

A 69-year-old man with a ruptured hepatocellular carcinoma （HC） was treated by hepatic transcatheter embolization （TAE） followed by upper segmentectomy of the liver. He developed postoperative intrahepatic recurrence and was treated with transcatheter arterial chemoembolization （TACE） at 6 months and 12 months postoperatively. Furthermore, chest computed tomography （CT） revealed a nodule suspected to be pleural metastasis 12 months postoperatively. Pathological assessment of a CT-guided biopsy of the nodule confirmed pleural metastasis of HC. Surgical resection of the metastatic tumor and adjuvant chemotherapy was performed. Despite developing lung metastasis, the patient has survived for more than 20 months. Early detection and treatment of pleural metastasis of HC might help to prolong survival.