個案報告:肝細胞癌之腎臟轉移瘤

郭育任、蔡育賢

成功大學附設醫院 泌尿部

A Rare Case of Hepatocellular Carcinoma Metastatic Tumor in Kidney

Yuh-Ren Kuo and Yuh-Shyan Tsai

Department of Urology, National Cheng Kung University Hospital, National Cheng Kung University

Background: Common origins of renal metastasis include lung, breast, and gastrointestinal cancers.

Renal metastasis arising from hepatocellular carcinoma was rare. Hence, we report a case of renal metastasis of hepatocellular carcinoma.

Case presentation: A 72- year-old female patient was previously diagnosed with hepatitis B and hepatocellular carcinoma. She underwent left lateral hepatectomy for the liver tumor in 2018. The pathological staging was pT2N0M0, stage II (by American Joint Committee on Cancer 8 th edition). After hepatectomy, serum alpha-fetoprotein remained stable and relatively low for 2 years. However, rising of alpha-fetoprotein was recognized since December 2020 and progressively elevated to 181ng/mL until May 2021. No recurrent tumor or distant metastasis was found on computed tomography. During follow-up, one enhancing nodule over right kidney was found on computed tomography. Enlargement of the renal tumor and gradually rising alpha-fetoprotein up to 288ng/ml were found afterwards. Thus, she

underwent right robot-assisted partial nephrectomy for renal tumor. The pathological diagnosis was a metastatic tumor from hepatocellular carcinoma. Her serum alpha-fetoprotein soon returned to within normal limit after the surgery.

Conclusions: Of all renal metastases, tumors arising from hepatocellular carcinoma were rarely reported. Herein, we report a female patient with solitary renal metastasis of hepatocellular carcinoma. A differential diagnosis of a metastatic renal tumor should not be neglected in a patient with a known history of hepatocellular carcinoma, particularly with rising alpha-fetoprotein.