Fibrolamellar Hepatocellular Carcinoma with Multiple Lung Metastases Treated with Multidisciplinary Therapy

Hiroki Tanaka; Susumu Hijioka; Hiromichi Iwaya; Nobumasa Mizuno; Takamichi Kuwahara; Nozomi Okuno; Ayako Ito; Naosuke Kuraoka; Shinpei Matsumoto; Masahiro Obata; Yusuke Kurita; Muneji Yasuda; Yasuhiro Shimizu; Hiroaki Kuroda; Yozo Sato; Masataka Haneda; Eiichi Sasaki; Yasushi Yatabe; Kazuo Hara

doi:10.2169/internalmedicine.1243-18

CASE REPORTS

Fibrolamellar Hepatocellular Carcinoma with Multiple Lung Metastases Treated with Multidisciplinary Therapy

Hiroki Tanaka, Susumu Hijioka, Hiromichi Iwaya, Nobumasa Mizuno, Takamichi Kuwahara, Nozomi Okuno, Ayako Ito, Naosuke Kuraoka, Shinpei Matsumoto, Masahiro Obata, Yusuke Kurita, Muneji Yasuda, Yasuhiro Shimizu, Hiroaki Kuroda, Yozo Sato, Masataka Haneda, Eiichi Sasaki, Yasushi Yatabe, Kazuo Hara

Author information

Hiroki Tanaka
Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
Department of Gastroenterology, Suzuka General Hospital, Japan
Susumu Hijioka
Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Japan
Hiromichi Iwaya
Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
Nobumasa Mizuno
Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
Takamichi Kuwahara
Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
Nozomi Okuno
Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
Ayako Ito
Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
Naosuke Kuraoka
Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
Shinpei Matsumoto
Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
Masahiro Obata
Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
Yusuke Kurita
Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
Muneji Yasuda
Department of Gastroenterology, Aichi Cancer Center Hospital, Japan
Yasuhiro Shimizu
Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Japan
Hiroaki Kuroda
Department of Thoracic Surgery, Aichi Cancer Center Hospital, Japan
Yozo Sato
Department of Diagnostic and Interventional Radiology, Aichi Cancer Center Hospital, Japan
Masataka Haneda
Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Japan
Eiichi Sasaki
Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Japan
Yasushi Yatabe
Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Japan
Kazuo Hara
Department of Gastroenterology, Aichi Cancer Center Hospital, Japan

Keywords: fibrolamellar hepatocellular carcinoma, multidisciplinary therapy, DNAJB1-PRKACA

JOURNAL OPEN ACCESS

2018 Volume 57 Issue 24 Pages 3537-3543

DOI https://doi.org/10.2169/internalmedicine.1243-18

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Abstract

A 20-year old man was diagnosed with fibrolamellar hepatocellular carcinoma (FLHCC) with multiple lung metastases, and chemotherapy with FOLFOX was administered. Contrast enhanced CT after 3 cycles of FOLFOX showed no disease progression. We therefore performed surgical resection and radiofrequency ablation of the liver lesions and lung metastases, after obtaining the patient's informed consent. The liver lesions and lung metastases tested positive for DNAJB1-PRKACA. The treatment for FLHCC with extrahepatic metastasis has not been established; however, in a few cases, good long-term prognoses were obtained with multidisciplinary therapy. We herein report a case of FLHCC with multiple lung metastases that was treated with multidisciplinary therapies.

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