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간세포암 완치 절제 4년 후 자궁에만 국소적으로 재발한 간세포암 1예

Localized Uterine Recurrence of Hepatocellular Carcinoma 4 Years after Curative Resection

  • 이상진 (울산대학교 의과대학 울산대학교병원 내과) ;
  • 신정우 (울산대학교 의과대학 울산대학교병원 내과) ;
  • 박능화 (울산대학교 의과대학 울산대학교병원 내과) ;
  • 나양원 (울산대학교 의과대학 울산대학교병원 외과) ;
  • 유항조 (울산대학교 의과대학 울산대학교병원 산부인과) ;
  • 정융기 (울산대학교 의과대학 울산대학교병원 영상의학과) ;
  • 최혜정 (울산대학교 의과대학 울산대학교병원 병리과)
  • Lee, Sang-Jin (Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Shin, Jung-Woo (Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Park, Neung-Hwa (Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Nah, Yang-Won (Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Yoo, Hang-Jo (Department of Obstetrics and Gynecology, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Jung, Yoong-Ki (Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Choi, Hye-Jeong (Department of Pathology, Ulsan University Hospital, University of Ulsan College of Medicine)
  • 발행 : 2012.05.01

초록

원발성 간세포암이 난소전이가 없이 자궁으로 전이하는 경우는 매우 드물다. 저자들은 4년 전 조기 간세포암으로 완치 절제술을 시행 받았던 환자에서 AFP의 점차적인 상승으로 재발을 진단하기 위한 검사에서 간내 간세포암의 재발 없이 자궁에만 국소적으로 재발한 전이성 간세포암 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Extrahepatic metastasis of hepatocellular carcinoma (HCC) can be found in various organs, but metastasis to the female genital tract is extremely rare. A 48-year-old woman who had undergone curative left lobectomy for small HCC 4 years earlier was admitted because of sequential alpha-fetoprotein elevation. Upon abdominal MRI and hepatic angiography, no evidence of HCC recurrence was found in the remnant liver. However, a positron emission tomography CT scan showed a hypermetabolic lesion in the uterine fundus, which was revealed as metastatic HCC after total hysterectomy. This is, to our knowledge, the first documented case of metastatic uterine tumor that originated from HCC without intrahepatic recurrence.

키워드

참고문헌

  1. Uka K, Aikata H, Takaki S, et al. Clinical features and prognosis of patients with extrahepatic metastases from hepatocellular carcinoma. World J Gastroenterol 2007;13:414-420. https://doi.org/10.3748/wjg.v13.i3.414
  2. Lo CM, Lai EC, Fan ST, Choi TK, Wong J. Resection for extrahepatic recurrence of hepatocellular carcinoma. Br J Surg 1994;81:1019-1021. https://doi.org/10.1002/bjs.1800810730
  3. Poon RT, Fan ST, O'Suilleabhain CB, Wong J. Aggressive management of patients with extrahepatic and intrahepatic recurrences of hepatocellular carcinoma by combined resection and locoregional therapy. J Am Coll Surg 2002;195:311-318. https://doi.org/10.1016/S1072-7515(02)01226-7
  4. Yang Y, Nagano H, Ota H, et al. Patterns and clinicopathologic features of extrahepatic recurrence of hepatocellular carcinoma after curative resection. Surgery 2007;141:196-202. https://doi.org/10.1016/j.surg.2006.06.033
  5. Kumar A, Schneider V. Metastases to the uterus from extrapelvic primary tumors. Int J Gynecol Pathol 1983;2:134-140. https://doi.org/10.1097/00004347-198302000-00004
  6. Katyal S, Oliver JH 3rd, Peterson MS, Ferris JV, Carr BS, Baron RL. Extrahepatic metastases of hepatocellular carcinoma. Radiology 2000;216:698-703. https://doi.org/10.1148/radiology.216.3.r00se24698
  7. Natsuizaka M, Omura T, Akaike T, et al. Clinical features of hepatocellular carcinoma with extrahepatic metastases. J Gastroenterol Hepatol 2005;20:1781-1787. https://doi.org/10.1111/j.1440-1746.2005.03919.x
  8. Charache H. Metastatic carcinoma in the uterus. Am J Surg 1941;53:152-157. https://doi.org/10.1016/S0002-9610(41)90463-4
  9. Ryo E, Sato T, Takeshita S, Ayabe T, Tanaka F. Uterine metastasis from hepatocellular carcinoma: a case report. Int J Gynecol Cancer 2006;16:1894-1896. https://doi.org/10.1111/j.1525-1438.2006.00668.x
  10. Kang WD, Kim CH, Cho MK, et al. Hepatocellular carcinoma presenting as uterine metastasis. Cancer Res Treat 2008;40:141-144. https://doi.org/10.4143/crt.2008.40.3.141
  11. Park UJ, Kim YH, Kang KJ, Lim TJ. Risk factors for early recurrence after surgical resection for hepatocellular carcinoma. Korean J Hepatol 2008;14:371-380. https://doi.org/10.3350/kjhep.2008.14.3.371
  12. Kanda M, Tateishi R, Yoshida H, et al. Extrahepatic metastasis of hepatocellular carcinoma: incidence and risk factors. Liver Int 2008;28:1256-1263. https://doi.org/10.1111/j.1478-3231.2008.01864.x
  13. Zhang BH, Yang BH, Tang ZY. Randomized controlled trial of screening for hepatocellular carcinoma. J Cancer Res Clin Oncol 2004;130:417-422.
  14. Nobuoka D, Kato Y, Gotohda N, et al. Postoperative serum alpha-fetoprotein level is a useful predictor of recurrence after hepatectomy for hepatocellular carcinoma. Oncol Rep 2010;24:521-528.
  15. Shin WY, Suh KS, Kim T, Jeon YM, Yi NJ, Lee KU. Could patients who underwent hepatic resection due to hepatocellular carcinoma with high alpha-fetoprotein be monitored for recurrence by alpha-fetoprotein level? Korean J Hepatol 2010;16: 168-175. https://doi.org/10.3350/kjhep.2010.16.2.168
  16. Stemmermann GN. Extrapelvic carcinoma metastatic to the uterus. Am J Obstet Gynecol 1961;82:1261-1266. https://doi.org/10.1016/S0002-9378(16)36251-2
  17. So BJ, Bekaii-Saab T, Bloomston MA, Patel T. Complete clinical response of metastatic hepatocellular carcinoma to sorafenib in a patient with hemochromatosis: a case report. J Hematol Oncol 2008;1:18. https://doi.org/10.1186/1756-8722-1-18
  18. Yeganeh M, Finn RS, Saab S. Apparent remission of a solitary metastatic pulmonary lesion in a liver transplant recipient treated with sorafenib. Am J Transplant 2009;9:2851-2854. https://doi.org/10.1111/j.1600-6143.2009.02860.x