Surgical management for lymph node recurrence of resected fibrolamellar hepatocellular carcinoma: A case report

Fibrolamellar hepatocellular carcinoma (FLHCC),which is quite uncommon in Japan, is known to be frequently associated with lymph node metastasis in-Western countries. Herein, we describe a case of a 25 year-old Japanese woman with recurrent FLHCC in the lymph nodes after undergoing right hepatic lobectomy. She underwent a second operation for removal of a recurrent celiac lymph node tumor 23 months after the initial operation. In Japan, the frequency of lymph node metastasis in ordinary hepatocellular carcinoma is only 1.6%, whereas 3 out of 9 (33%) reported domestic FLHCCs including this case had lymph node metastasis. The surgical management of lymph node metastasis in FLHCC is discussed.