Shiratori Masatoshi, Nagashima Ikuo, Takada Tadahiro, Morofuji Shinichiro, Motomiya Hiroshi, Matsuda Keiji, Inaba Tsuyoshi, Fukushima Junichi, Okinaga Kota
Department of Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8606, Japan.
J Hepatobiliary Pancreat Surg. 2004;11(6):426-9. doi: 10.1007/s00534-004-0921-8.
We report a 51-year-old man with a ruptured hepatocellular carcinoma (HCC). He was admitted to the hospital with abdominal pain and distension. Imaging studies revealed massive ascites, liver cirrhosis, and a 3-cm tumor at the inferior edge of the medial segment of the liver, with adhesions to the greater omentum. Abdominal paracentesis showed bloody ascites, and the patient was diagnosed with a ruptured HCC. OK-432, an immunomodulatory agent prepared from an attenuated strain of Streptococcus pyogenes, was injected (10 KE) into the peritoneal cavity four times within 1 week; the massive ascites disappeared, and the serum alpha-fetoprotein (AFP) level decreased to within the normal limits. Afterwards, he underwent a curative operation for HCC. His postoperative course was uneventful and he was discharged from the hospital on the twenty-second postoperative day. He had shown no evidence of recurrence or metastases at the time he died of hepatic failure related to alcohol abuse 9 months after the operation.
我们报告了一名51岁肝细胞癌（HCC）破裂的男性患者。他因腹痛和腹胀入院。影像学检查显示大量腹水、肝硬化，肝脏左内叶下缘有一个3厘米的肿瘤，与大网膜粘连。腹腔穿刺抽出了血性腹水，该患者被诊断为HCC破裂。将一种由减毒化脓性链球菌菌株制备的免疫调节剂OK - 432（10KE）在1周内分4次注入腹腔；大量腹水消失，血清甲胎蛋白（AFP）水平降至正常范围内。之后，他接受了HCC根治性手术。术后恢复顺利，术后第22天出院。术后9个月，他死于与酒精滥用相关的肝衰竭，当时无复发或转移迹象。
