A Hepatocellular Carcinoma Which Developed Mesenteric Recurrence after Hepatectomy

• Published in: Nippon Shokaki Geka Gakkai zasshi Vol. 49; no. 7; pp. 641 - 648
• Main Authors: Fukuoka, Tomoki, Koshikawa, Katsumi, Sanada, Shotaro, Sawaki, Kohichi, Oya, Hisaharu, Nishio, Tomoko
• Format: Journal Article
• Language: Japanese; English
• Published: The Japanese Society of Gastroenterological Surgery 2016
• Subjects: hepatocellular carcinoma; intravenous tumor emboli; metastasis to the mesentery
• ISSN: 0386-9768; 1348-9372
• DOI: 10.5833/jjgs.2015.0099

Until recently, no case had been reported in Japan of hepatocellular carcinoma which developed isolated mesenteric recurrence after hepatectomy. We encountered such a case, which occurred 13 years after hepatectomy. The patient was an 82-year-old man who received resection of 3 right-liver segments for hepatocellular carcinoma at age of 69, and distal gastrectomy for early gastric carcinoma at age 78 in our hospital. Thirteen years after hepatectomy, he developed anemia and an abdominal CT scan was performed. Multiple tumors were detected within the mesentery supplied by the ileocolic artery/vein, along with tumor emboli inside the ileocolic vein. Although congestion was observed in the ileum supplied by these vessels, no neoplastic lesion was detected. Resection was performed for diagnostic/treatment purposes. The tumor emboli were removed, and the artery and vein were separated at the base. Then the mesentery of the affected area and the intestinal tract supplied by these vessels were resected. The tumors had been partially squashed by themselves inside the ileac lumen, suggesting that this was probably the cause of anemia. The histopathological examination revealed that it was a metastasis of hepatocellular carcinoma, and the histological image was similar to that of the previous hepatocellular carcinoma.