中西 徹¹, 林 宏輔², 河村 哲雄², 小川 博康², 田上 展子³, 尾羽根 範員³, 三浦 融³

Toru NAKANISHI¹, Kousuke HAYASHI², Tetsuo KAWAMURA², Hiroyasu OGAWA², Nobuko TAGAMI³, Norikazu OBANE³, Tooru MIURA³

¹住友病院内科, ²住友病院外科, ³住友病院超音波室

¹Department of Internal Medicine, Sumitomo Hospital, ²Department of Surgery, Sumitomo Hospital, ³Department of Ultrasonography, Sumitomo Hospital

キーワード : Ectopic hepatocellular Carcinoma, Alpha-fetoprotein, Retoroperitoneal tumor , Type C liver cirrhosis

A unusual retoroperitoneal tumor, which was thought to be a ectopic hepatocellular carcinoma, is presented and four reported cases from previous Japanese literature are reviewed. The patient was 63-year-old man with type C liver cirrhosis. Significantly elevated AFP levels and retoroperitoneal tumor (size 3.6 cm) was shown on the inferior vena cava, but there were no primary foci in the liver for more than 36 months of follow-up as seen by several imaging techniques : US, CT, MRI and angiography. Yolk sac tumor and gastrointestinal cancer were ruled out by the use of AFP analysis with microheterogeneity and endoscopy. Finaly our case was diagnosed as hepatoma by surgical resection of the tumor. These clinical data and results of long-term follow-up suggest a high possibility of a ectopic hepatocellular carcinoma, however, the conclusion is not clear cut because of the absence of ectopic liver tissue in the tumor of our case. In addition, none of the other repoted cases have revealed ectopic liver tissues.