[A case of recurred small hepatocellular carcinoma as a solitary lymph node metastasis after hepatic resection]

Extrahepatic recurrence of hepatocellular carcinoma (HCC) has been considered unsuitable for surgical resection since the disease is considered to be extensive. However, solitary local lymph node recurrence in small HCC is rarely reported with suitable treatment modality being uncertain. We herein, present a case of 60-year-old female patient with small HCC showing late lymph node metastasis after complete resection of primary HCC. A 2 cm-sized hepatic mass was completely resected by segmentectomy (VIII). Eight months later, CT and PET scan revealed a 4.5 cm-sized portocaval lymph node (LN). In addition, whole body PET/CT scan strongly suggested a solitary tumor recurrence. Radical lymphadenectomy was performed. Tumor was confirmed as LN metastasis from HCC by excisional histopathological examination. Adjuvant chemotherapy and radiotherapy were followed.