Kinoshita H, Tanimura H, Onishi H, Kasano Y, Uchiyama K, Yamaue H
Second Department of Surgery, Wakayama Medical School, 811-1 Kimiidera, Wakayama 641-0012, Japan.
Hepatogastroenterology. 2001 Jan-Feb;48(37):250-2.
Biliary cystadenocarcinoma of the liver is a relatively rare disease. Herein, we reported a case of biliary cystadenocarcinoma with a review of the literature. A 71-year-old female was admitted with the chief complaint of epigastralgia. The imaging studies revealed a biliary cystadenocarcinoma in the left hepatic lobe with suspicion of direct invasion to the left and middle hepatic veins and inferior vena cava. However, there was no direct invasion of the tumor to these veins in operation findings, and an extended left hepatic resection was performed without resection of inferior vena cava. The tumor was histologically diagnosed as biliary cystadenocarcinoma of the liver. Diagnosis of biliary cystadenocarcinoma is usually difficult preoperatively, however, a diagnosis was possible with the use of imaging studies. It was suggested that this tumor originated from a benign cystadenoma because of the existence of a transitional zone between normal cells and atypical cells in the cystic wall. Systematic hepatectomy was recommended as the initial treatment in consideration of the features of cystadenocarcinoma.
肝内胆管囊腺癌是一种相对罕见的疾病。在此，我们报告一例肝内胆管囊腺癌病例并复习相关文献。一名71岁女性因上腹部疼痛为主诉入院。影像学检查显示左肝叶有胆管囊腺癌，怀疑肿瘤直接侵犯左、中肝静脉及下腔静脉。然而，手术所见肿瘤并未直接侵犯这些静脉，遂行扩大左肝切除术，未切除下腔静脉。肿瘤经组织学诊断为肝内胆管囊腺癌。术前通常难以诊断胆管囊腺癌，但通过影像学检查有可能作出诊断。鉴于囊壁正常细胞与非典型细胞之间存在过渡区，提示该肿瘤起源于良性囊腺瘤。考虑到囊腺癌的特点，建议将系统性肝切除术作为初始治疗方法。
