術後10年以上経過後の肝転移に対し2回の肝切除を施行し得た小腸平滑筋肉腫の1例

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  • A CASE OF LEIOMYOSARCOMA OF THE SMALL INTESTINE UNDERGONE TWICE HEPATECTOMIES FOR HEPATIC METASTASES OVER TEN YEARS AFTER PRIMARY RESECTION

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The liver is the most common site of metastasis for leiomyosarcoma of the small intestine. But because of its poor prognosis, only 33 cases of hepatectomy for hepatic metastasis have been described in the Japanese literature. We report a case of small bowel leiomyosarcoma undergoing hepatectomy twice for hepatic metastases over ten years after the primary resection, with a review of the literature on the role of hepatectomy for liver matastasis. A 65-year-old man was detecyed having liver tumors by ultrasonography 11 years after a resection of leiomyosarcoma of the small intestine. Magnetic resonance imaging revealed circumscribed oval tumors and angiography visualized hypervascular tumors. Examination of core needle biopsy under ultrasonography resulted in liver metastases from the small bowel leiomyosarcoma, and a hepatectomy was performed. One year after hepatectomy, another liver metastases were detected and a hepatectomy was performed again. Both resected tumors were diagnosed as liver metastases from small bowel leiomyosarcoma histopathologically. He is now doing well without recurrence one year after the second hepatectomy. It is thought that surgical procedure for liver metastasis from small bowel leiomyosarcoma, if possible, isbeneficial for prolonging the survival.

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