간내 원발 병소가 뚜렷하지 않고 폐전이로 확진된 간세포암종 1예

Abstract

Hepatocellular carcinoma (HCC) is a common malignancy and hepatitis B infection is known to be its most common etiologic factor. The most common metastatic site of extrahepatic spread is the lung. We report here on a case of a patient who presented with pulmonary metastasis as the first clinical manifestation of HCC. A 62-year-old-male patient showed an elevated α-fetoprotein level during follow up for chronic hepatitis B and liver cirrhosis. The existence of HCC was suspected and an empirical imaging diagnosis was performed. However, repeated computer tomography (CT), magnetic resonance imaging and hepatic angiography failed to detect any HCC. After 12 months, chest CT and PET (positron emission tomography) revealed lung nodules. Histologically, the resected lesion was confirmed as metastatic tumor from HCC. The establishment of the diagnosis of metastatic HCC can occasionally be problematic, particularly when the primary tumor has not been identified. A systemic approach to diagnosis and treatment should be followed