A surgically treated case of solitary lung metastasis of hepatocellular carcinoma with successful preoperative induction therapy by recycled bronchial arterial infusion and irradiation

A 52-year-old man was admitted with a solitary lung metastasis in the right pulmonary hilum from hepatocellular carcinoma. He had survived 13 months free of disease following posterior segmentectomy for the primary HCC. The metastatic tumor invading in mediastinum was selected for preoperative induction therapy. After thee cycles of bronchial arterial in fusion(BAI) and 50 Gy gamma-ray irradiation, the tumor was reduced to 27.7% of its former size on computed tomography scans, and partial responce(PR) was obtained. At operation, mediastinal invasion of the tumor was found to have been attenuated and the tumor was resected by right upper lobectomy. Since the tumor reduction after the third BAI using vindesine, cisplatin and mitomycin C(MVP) was noticeable, MVP may be a very useful regimen for BAI in cases of pulmonary metastasis of HCC. Induction therapy composed of recycled BAI using MVP and irradiation may increase resectability in cases of pulmonary metastasis of HCC.