制癌剤の局所動脈内注入にて治癒したと考えられる原発性肝癌の一剖検例

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A 56 year-old male patient was admitted to the Nippon Kokan Hospital with a chief complaint of dullness in the epigastrium in Feburary, 1974. He was previously found to have asmall hepatic tumor in the right lobe during his first admission in Feburary, 1972, for the treatment of gastric ulcer. On physical examination the tumor mass was palpated and radioisotopic scanning of the liver using 198Au colloid revealed a "cold" area in the lower portion of the right lobe. Laboratory examination disclosed an elevated level of serum Alphafetoprotein as high as 10, 217 ng/ml by radioimmunoassay method. Selective celiac angiography showed that the tumor vessels were proliferated over the almost entire right lobe. Subsequently the one shot infusion chemotherapy using Mitomycin C 20 mg was performed through the Seldinger catherter wedged in the celiac artery. The immunological treatment with Hasumi Vaccine was started 4 days after the infusion chemotherapy. The hepatic tumor apparently responded to the therapy resulting in the diminution of the liver size which suggested a disappearance of the tumor. The level of Alpha-fetoprotein was returned to the normal range (8 ng/ml). One year and 10 months after the infusion chemotherapy, he died suddenly of the ruptureof esophageal varices. Histological examination revealed that there were no cancer cells in any portion of the liver. Moreover the liver was without cirrhotic changes, although there was a walnut sized scar tissue at the lower portion of right lobe of the liver and number of coiled branches of hepatic arteries and portal veins with thorombi occupied these fibrous tissues. These data suggest that this is a rare case of primary hepatocellular carcinoma resultingin complete cure by a combination of chemotherapy and immunological treatment.
社団法人日本肝臓学会の論文

制癌剤の局所動脈内注入にて治癒したと考えられる原発性肝癌の一剖検例

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