Pharyngeal metastasis following living-donor liver transplantation for hepatocellular carcinoma: a case report and literature review
Abstract Background The most common sites of recurrence after liver transplantation for hepatocellular carcinoma (HCC) have been reported to be the liver, lung, bone, and adrenal glands, but there have also been many reports of cases of multiple recurrence. The prognosis after recurrence is poor, wi...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-05-01
|
| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12957-020-01873-0 |
| _version_ | 1819042233318375424 |
|---|---|
| author | Taiji Tohyama Katsunori Sakamoto Kei Tamura Taro Nakamura Jota Watanabe Hiroyuki Wakisaka Yasutsugu Takada |
| author_facet | Taiji Tohyama Katsunori Sakamoto Kei Tamura Taro Nakamura Jota Watanabe Hiroyuki Wakisaka Yasutsugu Takada |
| author_sort | Taiji Tohyama |
| collection | DOAJ |
| description | Abstract Background The most common sites of recurrence after liver transplantation for hepatocellular carcinoma (HCC) have been reported to be the liver, lung, bone, and adrenal glands, but there have also been many reports of cases of multiple recurrence. The prognosis after recurrence is poor, with reported median survival after recurrence of HCC ranging from 9 to 19 months. Here, we report a case of long-term survival after recurrence of pharyngeal metastasis following living-donor liver transplantation (LDLT) for HCC within the Milan criteria, by resection of the metastatic region and cervical lymph node dissection. Case presentation A 47-year-old man with a Model End-stage Liver Disease (MELD) score of 11 underwent LDLT for HCC within the Milan criteria for liver cirrhosis associated with hepatitis B virus infection, with his 48-year-old elder brother as the living donor. One year and 10 months after liver transplantation, he visited a nearby hospital with a chief complaint of discomfort on swallowing. A pedunculated polyp was found in the hypopharynx, and biopsy revealed HCC metastasis. We performed pharyngeal polypectomy. Two years later, cervical lymph node metastasis appeared, and neck lymph node dissection was performed. Although recurrence subsequently occurred three times in the grafted liver, the patient is still alive 12 years and 10 months after recurrence of pharyngeal metastasis. He is now a tumor-free outpatient taking sorafenib. Conclusion It is necessary to recognize that the nasopharyngeal region is a potential site of HCC metastasis. Prognostic improvement can be expected with close follow-up, early detection, and multidisciplinary treatment, including radical resection. |
| first_indexed | 2024-12-21T09:37:38Z |
| format | Article |
| id | doaj.art-3a115cf8a78a493fa93334c291ab46a8 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-12-21T09:37:38Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-3a115cf8a78a493fa93334c291ab46a82022-12-21T19:08:35ZengBMCWorld Journal of Surgical Oncology1477-78192020-05-011811810.1186/s12957-020-01873-0Pharyngeal metastasis following living-donor liver transplantation for hepatocellular carcinoma: a case report and literature reviewTaiji Tohyama0Katsunori Sakamoto1Kei Tamura2Taro Nakamura3Jota Watanabe4Hiroyuki Wakisaka5Yasutsugu Takada6Department of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of MedicineDepartment of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of MedicineDepartment of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of MedicineDepartment of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of MedicineDepartment of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of MedicineLaboratory of Head and Neck Surgery, Ehime Prefectural University of Health SciencesDepartment of Hepato-Biliary-Pancreatic and Breast Surgery, Ehime University Graduate School of MedicineAbstract Background The most common sites of recurrence after liver transplantation for hepatocellular carcinoma (HCC) have been reported to be the liver, lung, bone, and adrenal glands, but there have also been many reports of cases of multiple recurrence. The prognosis after recurrence is poor, with reported median survival after recurrence of HCC ranging from 9 to 19 months. Here, we report a case of long-term survival after recurrence of pharyngeal metastasis following living-donor liver transplantation (LDLT) for HCC within the Milan criteria, by resection of the metastatic region and cervical lymph node dissection. Case presentation A 47-year-old man with a Model End-stage Liver Disease (MELD) score of 11 underwent LDLT for HCC within the Milan criteria for liver cirrhosis associated with hepatitis B virus infection, with his 48-year-old elder brother as the living donor. One year and 10 months after liver transplantation, he visited a nearby hospital with a chief complaint of discomfort on swallowing. A pedunculated polyp was found in the hypopharynx, and biopsy revealed HCC metastasis. We performed pharyngeal polypectomy. Two years later, cervical lymph node metastasis appeared, and neck lymph node dissection was performed. Although recurrence subsequently occurred three times in the grafted liver, the patient is still alive 12 years and 10 months after recurrence of pharyngeal metastasis. He is now a tumor-free outpatient taking sorafenib. Conclusion It is necessary to recognize that the nasopharyngeal region is a potential site of HCC metastasis. Prognostic improvement can be expected with close follow-up, early detection, and multidisciplinary treatment, including radical resection.http://link.springer.com/article/10.1186/s12957-020-01873-0Hepatocellular carcinomaPharyngeal metastasisNasopharynxLiver transplantationVertebral venous plexus |
| spellingShingle | Taiji Tohyama Katsunori Sakamoto Kei Tamura Taro Nakamura Jota Watanabe Hiroyuki Wakisaka Yasutsugu Takada Pharyngeal metastasis following living-donor liver transplantation for hepatocellular carcinoma: a case report and literature review World Journal of Surgical Oncology Hepatocellular carcinoma Pharyngeal metastasis Nasopharynx Liver transplantation Vertebral venous plexus |
| title | Pharyngeal metastasis following living-donor liver transplantation for hepatocellular carcinoma: a case report and literature review |
| title_full | Pharyngeal metastasis following living-donor liver transplantation for hepatocellular carcinoma: a case report and literature review |
| title_fullStr | Pharyngeal metastasis following living-donor liver transplantation for hepatocellular carcinoma: a case report and literature review |
| title_full_unstemmed | Pharyngeal metastasis following living-donor liver transplantation for hepatocellular carcinoma: a case report and literature review |
| title_short | Pharyngeal metastasis following living-donor liver transplantation for hepatocellular carcinoma: a case report and literature review |
| title_sort | pharyngeal metastasis following living donor liver transplantation for hepatocellular carcinoma a case report and literature review |
| topic | Hepatocellular carcinoma Pharyngeal metastasis Nasopharynx Liver transplantation Vertebral venous plexus |
| url | http://link.springer.com/article/10.1186/s12957-020-01873-0 |
| work_keys_str_mv | AT taijitohyama pharyngealmetastasisfollowinglivingdonorlivertransplantationforhepatocellularcarcinomaacasereportandliteraturereview AT katsunorisakamoto pharyngealmetastasisfollowinglivingdonorlivertransplantationforhepatocellularcarcinomaacasereportandliteraturereview AT keitamura pharyngealmetastasisfollowinglivingdonorlivertransplantationforhepatocellularcarcinomaacasereportandliteraturereview AT taronakamura pharyngealmetastasisfollowinglivingdonorlivertransplantationforhepatocellularcarcinomaacasereportandliteraturereview AT jotawatanabe pharyngealmetastasisfollowinglivingdonorlivertransplantationforhepatocellularcarcinomaacasereportandliteraturereview AT hiroyukiwakisaka pharyngealmetastasisfollowinglivingdonorlivertransplantationforhepatocellularcarcinomaacasereportandliteraturereview AT yasutsugutakada pharyngealmetastasisfollowinglivingdonorlivertransplantationforhepatocellularcarcinomaacasereportandliteraturereview |