Aggressive Surgical Management of Recurrent Lymph Node and Pancreatic Head Metastases of Resected Fibrolamellar Hepatocellular Carcinoma: A Case Report

摘要

Context Fibrolamellar hepatocellularcarcinoma is a rare liver tumor with the propensity to metastasize to the lymphnodes months or years after initial surgery. However, its metastatic spread tothe pancreas was previously reported only in a child. Case report Wepresent an unusual case of a young female patient who was repeatedly treated bysurgical excision of abdominal and mediastinal lymph node recurrences between 2and 6 years after left hepatic lobectomy for fibrolamellar hepatocellularcarcinoma. At 8 years following her initial surgery, the patient was diagnosedwith pancreatic head metastasis and a pancreaticoduodenectomy was performed.Postoperative course was uneventful and the patient did not experiencerecurrence within the last 18 months. Conclusion The metastasis offibrolamellar hepatocellular carcinoma to the pancreas is highly exceptionalbut possible and its excision appears warranted as well.