TY - JOUR
T1 - A long-term survival case of metachronous para-aortic lymph node metastasis from intrahepatic cholangiocarcinoma, staining in the early phase with chronic virus-related hepatitis
AU - Nobuoka, Daisuke
AU - Nakagohrf, Toshio
AU - Kitada, Koji
AU - Kato, Yuichiro
AU - Gotohda, Naoto
AU - Kinoshita, Takahiro
AU - Takahashi, Shinichiro
AU - Konishi, Masaru
AU - Kojima, Motohiro
AU - Kinoshita, Taira
PY - 2011
Y1 - 2011
N2 - Lymph node metastasis is one of the most serious prognostic factors in patients with intrahepatic cholangiocarcinoma. Furthermore, treatment of recurrent intrahepatic cholangiocarcinoma is difficult. We report a rare case of long-term survival in a patient who had metachronous para-aortic lymph node metastasis from intrahepatic cholangiocarcinoma. A 70-year-old man was followed up after endoscopic mu-cosal resection for esophageal cancer and referred to our section with space-occupying lesion of the liver. Computed tomography (CT) demonstrated a 3.0-cm-diameter tumor located in S6, which was hy-perattenuated in the early phase. Tumor cells were heptitis B antigen positive. He underwent partial hepatectomy under a preoperative diagnosis of hepatocellular carcinoma. The histopathological diagnosis was intrahepatic cholangiocarcinoma. At 16 months after the first operation, CT showed a swollen lymph node behind the inferior vena cava. After the second operation, we diagnosed metachronous para-aortic lymph node metastasis of intrahepatic cholangiocarcinoma. At 26 months after the first operation, a swollen lymph node around the celiac artery was found. He underwent a third operation at another institution. The histopathological findings were moderately differentiated adenocarcinoma, which was the same as the previously resected tumors. The patient is still alive without recurrence 3 years after the third resection and over 5 years after the first operation.
AB - Lymph node metastasis is one of the most serious prognostic factors in patients with intrahepatic cholangiocarcinoma. Furthermore, treatment of recurrent intrahepatic cholangiocarcinoma is difficult. We report a rare case of long-term survival in a patient who had metachronous para-aortic lymph node metastasis from intrahepatic cholangiocarcinoma. A 70-year-old man was followed up after endoscopic mu-cosal resection for esophageal cancer and referred to our section with space-occupying lesion of the liver. Computed tomography (CT) demonstrated a 3.0-cm-diameter tumor located in S6, which was hy-perattenuated in the early phase. Tumor cells were heptitis B antigen positive. He underwent partial hepatectomy under a preoperative diagnosis of hepatocellular carcinoma. The histopathological diagnosis was intrahepatic cholangiocarcinoma. At 16 months after the first operation, CT showed a swollen lymph node behind the inferior vena cava. After the second operation, we diagnosed metachronous para-aortic lymph node metastasis of intrahepatic cholangiocarcinoma. At 26 months after the first operation, a swollen lymph node around the celiac artery was found. He underwent a third operation at another institution. The histopathological findings were moderately differentiated adenocarcinoma, which was the same as the previously resected tumors. The patient is still alive without recurrence 3 years after the third resection and over 5 years after the first operation.
KW - Intrahepatic cholangiocarcinoma
KW - Lymph node metastasis
KW - Recurrence
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U2 - 10.5833/jjgs.44.1142
DO - 10.5833/jjgs.44.1142
M3 - Article
AN - SCOPUS:83455237290
VL - 44
SP - 1142
EP - 1150
JO - Japanese Journal of Gastroenterological Surgery
JF - Japanese Journal of Gastroenterological Surgery
SN - 0386-9768
IS - 9
ER -