Fig. 3

Clinical course of patient with pharyngeal metastasis after living-donor liver transplantation (LDLT) for hepatocellular carcinoma (HCC). Tacrolimus and mycophenolate mofetil were used as posttransplant immunosuppressive agents, with no steroid administration. Epirubicin was administered during surgery. Pharyngeal metastasis occurred at 1 year and 10 months after LDLT. In addition, at 2 years after pharyngeal polypectomy, recurrence of HCC was detected in the regional neck lymph nodes. Recurrence subsequently occurred three times in the grafted liver, and local treatment with transcatheter arterial chemoembolization and radiofrequency ablation therapy were performed. The patient took TS-1 orally after pharyngeal polypectomy for approximately 1 year and 6 months, and oral administration of sorafenib was started after the second liver graft recurrence