Abstract
A 77-year-old man, who had a tumor in segment 8 of his liver, was diagnosed with hepatocellular carcinoma based on abdominal ultrasonography. The pathological diagnosis was well-differentiated hepatocellular carcinoma. One year after the first surgery, tumors in S2 and S3 appeared, and they were suspected tumors of hepatocellular carcinoma, whereas a tumor in S4 had high fluorodeoxyglucose uptake on positron emission tomography with ring enhancement. The tumors in S2 and S3 were subjected to radiofrequency ablation, and the tumor in S4 was partially resected. Histopathologically, the tumor in S4 was a combined hepatocellular carcinoma-cholangiocellular carcinoma. Two years after the first surgery, multiple recurrences in S3 of the liver and gastric lesser curvature lymph node metastasis were observed. The intrahepatic lesions were well controlled by chemotherapy 6 months after the initiation of lenvatinib treatment, but the gastric lesser curvature lymph node showed a tendency of enlargement, and surgical resection was performed. The pathological diagnosis was metastatic combined hepatocellular carcinoma-cholangiocellular carcinoma. Three years after the first hepatectomy, lenvatinib treatment is ongoing without recurrence.
We encountered a case in which multidisciplinary treatment of surgical resection and lenvatinib was effective for disease control in a patient with metachronous double cancer of hepatocellular carcinoma and combined hepatocellular carcinoma-cholangiocellular carcinoma.
