Three pulmonary resections for metastatic lung cancer from hepatocellular carcinoma

We describe a patient who underwent pulmonary resection three times for metastatic lung cancer from hepatocellular carcinoma (HCC). A 56-year-old man, who had a past history of right hepatic lobectomy for HCC, was referred to our department with an abnormal finding on chest computed tomography (CT). Chest CT showed three abnormal shadows, in the right upper lobe (S3b), right middle lobe (S5), and right lower lobe (S10), respectively, and there was no evidence of intrahepatic recurrence. He underwent surgical resections (right upper lobectomy and partial resections) for the metastatic lung cancer from HCC. Subsequently, 12 and 16 months after the first pulmonary resection, metastatic lung cancer recurred, in right S6 and S9, respectively. Because there was no evidence of intrahepatic recurrence and because of the feasibility of curative resection, we performed partial pulmonary resections. He had no postoperative morbidity, and is alive with no evidence of disease 60 months after the first pulmonary resection. Twelve cases of repeat pulmonary resections for metastatic lung cancer from HCC have been reported in the literature, and the authors of these reports described that repeated pulmonary resections for metastatic lung cancer from HCC resulted in long-term survival. Repeat pulmonary resections for metastatic lung cancer from HCC can be an effective treatment for patients with such metastases.