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We experienced a case of solitary splenic metastasis after hepatectomy for hepatocelluler carcinoma. The case was a 69-years-old female without liver cirrhosis or hepatitis. She underwent “so called Right Liver Trisegmentectomy” for large hepatic tumor on November 16, 1993. Pathological findings revealed trabecular type moderately differentiated hepatocellular carcinoma. fc (+), fc-inf (+), Vp0, Vv0, b0, tw (-), im 1. Seven months later, we observed multiple liver metastasis and a low density splenic tumor of 2cm diameter by computed tomography. We perfomed Trans arterial embolization on the liver metastasis, but the splenic tumor had enlaged to 4cm diameter. We diagnosed the splenic tumor as metastasis of hepatocellular carcinoma. She underwent splenectomy on March 20, 1995. Before and during the operation, we found other evidence of metastatic tumors except for those detected in the liver and spleen. Immunological competence levels were within the normal range. There had been 8 cases of solitary splenic metastasis of hepatocellular carcinoma reported in Japan, and only 2 were resected.

Intrahepatic metastasis via the portal venous system and bloodborne distant metastasis are common in hepatocellular carcinoma. However, lymph node metastasis after resection of hepatocellularcarcinoma is rare. and recurrence of lymph node metastasis after surgical resection is also rare. On the other hand, detection of lymph node metastasis has been reported in about 30% of autopsy cases. We carried out this clinicopathological study to assess patients positive for lymph node metastasis among those who underwent surgical resection of hepatocellular carcinoma. A total of 951 patients underwent resection of HCC in our department during the period from 1983 to 1995, and 57 of them, the lymph nodes were dissected or the hepatoduodenal liga-ment and superior pancreatic rim alone were sampled intraoperatively because lymph node enlargement was noted during surgery. Histological examination showed lymph node metastasis in 7 patients. The carcinomas were larger than 4cm in diameter in all 7 patients and had invaded other organs in 3 of them. Many metastic lymph nodes were detected in cases 8 and 12. Lymph node metastasis was associated with cirrhosis in one of them. All 7 patients had poorly-differentiated HCC, with extensive interstitial invasion. We analyzed the correlation between lymph node metastasis and levels of carcinoembryonic antigen (CEA), tumor grade and liver tissue. There was a significant correlation between these facters and lymph node metastasis (p