[A surgical case of solitary lymph node metastatic recurrence of hepatocellular carcinoma after hepatectomy].

The patient was a male in the sixties who received interferon therapy against hepatitis C. At first, the patient was pointed to having an increased alpha fetoprotein (AFP) level of 1104 ng/ml. Partial hepatectomy was performed against hepatocellular carcinoma (HCC) (segment 3, 44 mm in diameter) and diagnosed by further exams. The serum AFP level decreased to a normal range after hepatectomy for the time being. A rapid elevation of serum AFP level (11,293 ng/ml) was observed nine months after the surgery. No evidence of recurrence in the intra- and extra hepatic organs such as adrenal gland, lung, bone, and brain except for intra abdominal solitary lymph node metastasis was observed. Then the metastatic lymph node was removed surgically. After the removal of the lymph node, the serum AFP level decreased within a normal limit immediately. This patient currently survives without the disease for 30 months after the initial operation, and for 19 months after a resection of the meatastatic lymph node.