Abstract
A 69-year-old man developed hepatocellular carcinoma (HCC) in January 2005, and was treated by radiofrequency ablation (RFA). After the transcatheter arterial chemoembolization (TACE) and RFA had been repeated twice for recurrent HCCs, he admitted to our hospital due to recurrent HCC in S4 and lymphnode metastasis near the pancreas head. Celiac angiography showed a tumor stain in S4 and pancreas head area, measuring 35 mm and 25 mm in diameter respectively. The latter stain was recognized as a solitary hypervascular lymphnode metastasis near the pancreas head by CTHA. HCC in S4 was treated by TACE followed by RFA. The lymphnode metastasis which was treated by endoscopic ultrasonography-guided ethanol injection was successfully treated. A significant decrease in the size of the lymphnode and tumor markers were observed 2 months after treatment, and the lymphnode had almost disappeared 8 months later. All four cases of ethanol injection therapy against lymphnode metastasis of HCC in our hospital were treated successfully. The results in this case suggest that the ethanol injection therapy may be effective in the treatment of lymphnode metastasis of HCC, and endoscopic ultrasonography allows an easy approach to the lymphnode especially around the pancreas head area.
