内容紹介
Summary
A 65-year-old woman who had liver cirrhosis(Child-Pugh class B)due to hepatitis C infection was diagnosed with hepatocellular carcinoma with hepatic vein invasion, portal vein tumor invasion, and lung metastasis. No recommended treatment was noted in the clinical practice guidelines for hepatocellular carcinoma with vascular invasion in patients with Child-Pugh class B liver cirrhosis. After initiating arterial injection chemotherapy, marked decreases in tumor size of lung metastasis, vascular invasion, and primary liver cancer were observed. Based on our experience and previous reports, hepatic arterial infusion chemotherapy was considered valuable for hepatocellular carcinoma with vascular invasion, even in patients with Child-Pugh class B liver cirrhosis.
要旨
症例は65歳,女性。C型肝硬変にて近医に通院中であったが,肝静脈浸潤,門脈腫瘍浸潤,多発肺転移を伴う肝細胞癌と診断された。下大静脈浸潤が予後に影響すると考え肝動注化学療法を行ったところ,脈管浸潤や肝内病変のみならず,肺転移も含めて著明な縮小を認めた。科学的根拠に基づく肝癌診療ガイドライン上は,Child-Pugh分類Bの肝硬変症患者における脈管侵襲を伴う肝細胞癌に対する推奨治療は確立されていないが,下大静脈症候群を来した脈管浸潤症例に対して治療選択の一つになり得ると考え報告する。
目次
A 65-year-old woman who had liver cirrhosis(Child-Pugh class B)due to hepatitis C infection was diagnosed with hepatocellular carcinoma with hepatic vein invasion, portal vein tumor invasion, and lung metastasis. No recommended treatment was noted in the clinical practice guidelines for hepatocellular carcinoma with vascular invasion in patients with Child-Pugh class B liver cirrhosis. After initiating arterial injection chemotherapy, marked decreases in tumor size of lung metastasis, vascular invasion, and primary liver cancer were observed. Based on our experience and previous reports, hepatic arterial infusion chemotherapy was considered valuable for hepatocellular carcinoma with vascular invasion, even in patients with Child-Pugh class B liver cirrhosis.
要旨
症例は65歳,女性。C型肝硬変にて近医に通院中であったが,肝静脈浸潤,門脈腫瘍浸潤,多発肺転移を伴う肝細胞癌と診断された。下大静脈浸潤が予後に影響すると考え肝動注化学療法を行ったところ,脈管浸潤や肝内病変のみならず,肺転移も含めて著明な縮小を認めた。科学的根拠に基づく肝癌診療ガイドライン上は,Child-Pugh分類Bの肝硬変症患者における脈管侵襲を伴う肝細胞癌に対する推奨治療は確立されていないが,下大静脈症候群を来した脈管浸潤症例に対して治療選択の一つになり得ると考え報告する。