広範な肝内外門脈腫瘍塞栓を主体とし主腫瘍が同定困難であった肝細胞癌の1例

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  • A CASE OF HEPATOCELLULAR CARCINOMA IN WHICH NO PRIMARY LESION COULD BE IDENTIFIED DUE TO SCATTERED PORTAL TUMOR THROMBI

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A 67-year-old male complaining of general fatigue was diagnosed as liver cirrhosis (anti HCV-Ab positive) with a hepatocellular carcinoma in the anterior segment of the liver with remarkable portal tumor thrombus attained to the extrahepatic portal vein. Right lobectomy of the liver and evacuation of the portal tumor thrombus were performed. The histopathological findings revealed moderately-poorly differentiated hepatocellular carcinoma. In the resected specimen, multiple, small and white nodules were scattered which were all diagnosed as distal portal tumor thrombi, but no lesion suspecting of the primary lesion was found. It is thought that the tumor in this case invaded the portal vein in an extremely early phase and expressed widely through the portal vein both distal and peripheral sides.

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