Sano K, Kosuge T, Yamamoto J, Shimada K, Takayama T, Yamasaki S, Makuuchi M
Department of Surgery, National Cancer Center Hospital, Tokyo, Japan.
Hepatogastroenterology. 1999 Jul-Aug;46(28):2547-50.
Primary carcinoid tumor of the liver is very rare. Only 30 cases have been reported in the English literature. However, most of those cases were diagnosed only on the basis of diagnostic imaging and surgical exploration, their follow-up periods being up to 5 years. Considering the slow progression of the tumor, long-term follow-up is required to exclude occult extrahepatic primaries which may manifest afterwards, and to determine the clinical course of this disease. We experienced 3 patients with primary hepatic carcinoid tumors who underwent total resections. They all survived more than 7 years and were clinically confirmed as hepatic primary by failing to detect other primaries during their courses. One patient is disease-free for more than 7 years after resection. The other 2 were found to have recurrence in the remnant liver; 1 underwent transcatheter arterial embolization several times and is alive more than 4 years after recurrence, and the other underwent 2 more operations and survived 8 years after the 1st recurrence. Surgery might offer a possible chance of cure for primary hepatic carcinoid tumor, and transcatheter arterial embolization might be a good treatment option when an unresectable disease is confined to the liver.
原发性肝癌类癌非常罕见。英文文献中仅报道了30例。然而，这些病例大多仅根据诊断性影像学检查和手术探查确诊，其随访期长达5年。考虑到肿瘤进展缓慢，需要长期随访以排除可能随后出现的隐匿性肝外原发性肿瘤，并确定该疾病的临床病程。我们收治了3例接受全切除手术的原发性肝癌类癌患者。他们均存活超过7年，且在病程中未检测到其他原发性肿瘤，临床确诊为肝原发性肿瘤。1例患者术后无病生存超过7年。另外2例在残余肝脏中发现复发；1例多次接受经导管动脉栓塞术，复发后存活超过4年，另1例又接受了2次手术，首次复发后存活8年。手术可能为原发性肝癌类癌提供治愈机会，当不可切除的疾病局限于肝脏时，经导管动脉栓塞术可能是一种很好的治疗选择。
