内容紹介
A Case of Bone Metastases from Hepatocellular Carcinoma Presenting with Erythrocytosis after Hepatectomy
Summary
A 57-year-old man was admitted for careful examination of lower limb edema. Abdominal computed tomography(CT)showed hepatocellular carcinoma(HCC), 2 cm in diameter, arising in liver segment S6. Posterior segmentectomy was performed, and histological examination of the specimen revealed poorly differentiated HCC. Nine months after surgery, a metastatic tumor was detected in the left scapula, and the patient gradually began to show a high blood concentration of hemoglobin and erythropoietin(Epo). Sorafenib was started but was discontinued because of intractable diarrhea. The patient died of the metastatic tumor 15 months after surgery. This is the first case report of a patient with metastatic HCC developing erythrocytosis associated with a high concentration of Epo.
要旨
症例は57歳,男性。肝S6の直径2 cmの肝腫瘍を切除したところ,低分化型肝細胞癌であった。術後,α-fetoprotein値はいったん正常化したものの,術後4か月目に再上昇し,9か月目に左肩甲骨を中心に転移性骨腫瘍を認めた。転移巣は急速に増大し,同時期にヘモグロビン(Hb)が上昇した。術後14か月目のHbは19.1 g/dLで,エリスロポエチン値は179.5 mIU/mLと高値であった。また,喫煙や低酸素血症などによる二次性多血症はなかった。肝細胞癌に腫瘍随伴症候群として多血症は報告されているが,転移性骨腫瘍が多血症を呈した症例は認めないため報告した。
目次
Summary
A 57-year-old man was admitted for careful examination of lower limb edema. Abdominal computed tomography(CT)showed hepatocellular carcinoma(HCC), 2 cm in diameter, arising in liver segment S6. Posterior segmentectomy was performed, and histological examination of the specimen revealed poorly differentiated HCC. Nine months after surgery, a metastatic tumor was detected in the left scapula, and the patient gradually began to show a high blood concentration of hemoglobin and erythropoietin(Epo). Sorafenib was started but was discontinued because of intractable diarrhea. The patient died of the metastatic tumor 15 months after surgery. This is the first case report of a patient with metastatic HCC developing erythrocytosis associated with a high concentration of Epo.
要旨
症例は57歳,男性。肝S6の直径2 cmの肝腫瘍を切除したところ,低分化型肝細胞癌であった。術後,α-fetoprotein値はいったん正常化したものの,術後4か月目に再上昇し,9か月目に左肩甲骨を中心に転移性骨腫瘍を認めた。転移巣は急速に増大し,同時期にヘモグロビン(Hb)が上昇した。術後14か月目のHbは19.1 g/dLで,エリスロポエチン値は179.5 mIU/mLと高値であった。また,喫煙や低酸素血症などによる二次性多血症はなかった。肝細胞癌に腫瘍随伴症候群として多血症は報告されているが,転移性骨腫瘍が多血症を呈した症例は認めないため報告した。