COMBINED HEPATOCELLULAR CARCINOMA AND CHOLANGIOCARCINOMA WITH PORTAL VEIN THROMBOSIS-A CASE REPORT-

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  • OTA Hideo
    Department of Surgery, Graduate School of Medicine, Osaka University
  • NAGANO Hiroaki
    Department of Surgery, Graduate School of Medicine, Osaka University
  • UMESHITA Koji
    Department of Surgery, Graduate School of Medicine, Osaka University
  • WAKASA Kenichi
    Department of Pathology, Osaka City University Hospital
  • MONDEN Morito
    Department of Surgery, Graduate School of Medicine, Osaka University

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  • 門脈内腫瘍栓を伴う混合型肝癌の１切除例

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Abstract

A 52-year-old male underwent hepatic anterior segmentectomy and S4 and 7 partial hepatectomy, with portal venous tumor thrombectomy for advanced hepatocellular carcinoma (HCC) in February, 1999. Postoperative histological diagnosis was mixed type HCC. In the immunohistochemical analysis, expression of interferon-receptor (IFN-R) was positive in HCC component : negative in cholangiocellular carcinoma (CCC) component. A combined chemotherapy of IFN-α (5×106 units, i. s. c.) and 5-FU (300mg/m2/, i. a., continuous) was started as a postoperative adjuvant for the prevention of intra-hepatic recurrence. Eight months later, abdominal CT showed the recurrence of CCC component, in S7. We changed the protocol from IFN combined chemotherapy to arterial infusion chemotherapy with 5-FU, MMC and CDDP. One year later, abdominal CT indicated not only CCC component but also recurrence of HCC component. In this case, IFN combined chemotherapy might be effective in HCC component but ineffective in CCC component, related with the expression of IFN-R.

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