Owono P, Scoazec J Y, Valette P J, Dumortier J, Gouysse G, Berger F, Boulez J, Partensky C
Fédération des Spécialités Digestives, Hôpital Edouard-Herriot, Lyon, France.
Gastroenterol Clin Biol. 2001 Apr;25(4):414-21.
Hepatobiliary cystic tumors are rare, but must be correctly diagnosed because of their potential malignancy. We report the clinical, radiological, pathological and evolutive characteristics of 7 cases of hepatobiliary cystic tumors.
Complete clinical charts were available. Radiological and pathological documents were reviewed.
There were 4 females and 3 males (median age, 58.7 yrs). In 3 cases, the presenting symptom was the palpation of a mass in the right upper abdominal quadrant. In 6 cases, pre-operative imaging studies showed a cystic intra-hepatic mass, containing vegetations and/or septa in 5 cases. In the remaining case, the radiological appearance showed a heterogeneous liver mass. Two patients were treated by pericystectomy and 5 by radical hepatectomy. At macroscopic examination, tumors were usually large (range: 2-24 cm) and multilocular. Histological diagnosis was: cystadenoma with mesenchymous stroma (2 cases), mucinous cystadenoma (2 cases), mucinous cystadenocarcinoma (2 cases), giant cell cystadenocarcinoma (1 case). The mean duration of follow up was 60 months. Two patients, both with cystadenocarcinomas, died after respectively, 21 and 34 months with metastatic dissemination. Five patients are alive without evidence of disease after a delay ranging from 14 to 144 months.
Radical surgical treatment of cystic hepatobiliary tumors is necessary to obtain histopathological examination of the complete specimen, which is essential for a correct evaluation of the malignant potential of the lesion, and for prolonged survival, even in cases of locally invasive tumors.
肝胆囊性肿瘤较为罕见,但因其具有潜在恶性,必须正确诊断。我们报告7例肝胆囊性肿瘤的临床、放射学、病理学及演变特征。
有完整的临床病历。对放射学和病理学资料进行了回顾。
4例女性,3例男性(中位年龄58.7岁)。3例患者的首发症状为右上腹可触及肿块。6例患者术前影像学检查显示肝内囊性肿块,5例含有赘生物和/或分隔。其余1例患者的放射学表现为肝脏不均匀肿块。2例患者接受了囊肿切除术,5例接受了根治性肝切除术。大体检查显示,肿瘤通常较大(范围:2 - 24 cm)且为多房性。组织学诊断为:间质性基质囊腺瘤(2例)、黏液性囊腺瘤(2例)、黏液性囊腺癌(2例)、巨细胞囊腺癌(1例)。平均随访时间为60个月。2例黏液性囊腺癌患者分别在21个月和34个月后因转移扩散死亡。5例患者在14至144个月后存活,无疾病证据。
对囊性肝胆肿瘤进行根治性手术治疗对于获取完整标本的组织病理学检查是必要的,这对于正确评估病变的恶性潜能以及延长生存期至关重要,即使是局部浸润性肿瘤病例。