Hatano Etsuro, Ikai Iwao, Shimizu Masaki, Maetani Yoji, Konda Yoshitaka, Chiba Tsutomu, Terajima Hiroaki, Yamamoto Naritaka, Yamamoto Yuzo, Shimahara Yasuyuki, Yamaoka Yoshio
Department of Gastroenterological Surgery, Kyoto University of Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
Hepatogastroenterology. 2003 Jul-Aug;50(52):1034-6.
A 73-year-old man was admitted to our hospital on emergency for severe anemia. Upper gastrointestinal endoscopic study revealed a hemorrhagic ulcer in the duodenal bulb. He underwent endoscopic hemostasis. Abdominal ultrasonography and computed tomography showed a huge mass in segment 4 of the liver, growing into the extrahepatic space with direct invasion to the duodenal bulb. Extended left lobectomy and partial gastroduodenectomy was performed, because the endoscopic management of hemostasis was incomplete. He was discharged on the 30th postoperative day. Histopathologically, the tumor cells were moderately differentiated hepatocellular carcinoma with direct invasion to the duodenal mucosa. This report demonstrated the first case with a hepatocellular carcinoma with duodenal invasion, for which hepatic resection was performed successfully.
一名73岁男性因严重贫血急诊入院。上消化道内镜检查发现十二指肠球部有出血性溃疡。他接受了内镜止血治疗。腹部超声和计算机断层扫描显示肝4段有一个巨大肿块，长入肝外间隙并直接侵犯十二指肠球部。由于内镜止血处理不彻底，遂行扩大左肝叶切除术和部分胃十二指肠切除术。术后第30天出院。组织病理学检查显示，肿瘤细胞为中度分化的肝细胞癌，直接侵犯十二指肠黏膜。本报告展示了首例十二指肠受侵肝细胞癌并成功实施肝切除的病例。
