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肝脏孤立性纤维瘤

Solitary fibrous tumor of the liver.

作者信息

Vennarecci Giovanni, Ettorre Giuseppe Maria, Giovannelli Luca, Del Nonno Franca, Perracchio Letizia, Visca Paolo, Corazza Valerio, Vidiri Antonello, Visco Giuseppe, Santoro Eugenio

机构信息

Divisione di Chirurgia Digestiva e dei Trapianti, Istituto Regina Elena, Via E. Chianesi 53, 00144 Rome, Italy.

出版信息

J Hepatobiliary Pancreat Surg. 2005;12(4):341-4. doi: 10.1007/s00534-005-0993-0.

Abstract

We report a new case of benign solitary fibrous tumor (SFT) of the liver. A 65-year-old man presented to our unit with upper right abdominal discomfort. On examination abdominal distension was present and palpation showed a large firm mass in the right hypochondrium and epigastrium. The patient's past medical history was not significant and laboratory tests were normal. Ultrasonography and computed tomography showed a large tumor, 20 cm in diameter, in the right lobe of the liver. An extended right hepatectomy was performed. The tumor measured 30 x 28 x 14 cm and weighed 4725 g. Microscopic evaluation showed a benign SFT of the liver with tumor cells typically positive for vimentin and CD34. The postoperative course was uneventful, and the patient is alive 30 months after surgery. This is a rare neoplasm of mesenchymal origin that occasionally involves the liver in adult patients. Most SFTs are benign, but some may have malignant histological features and recur locally or metastasize. Because of their rarity, overall experience has not been significant and little has been published concerning this tumor, Including the present one, 28 cases have been reported in the English literature. Surgery is the mainstay of treatment. Little can be said about the benefits of adjuvant radiochemotherapy in these patients. As SFT of the liver is often a benign neoplasm, chemotherapy or radiotherapy should not be necessary, and should be reserved for when resection is incomplete and/or histological examination reveals features of malignancy. Surgeons must be aware of SFT of the liver, and this neoplasm should be included in the differential diagnosis of a single large hepatic mass.

摘要

我们报告了一例新的肝脏良性孤立性纤维瘤(SFT)病例。一名65岁男性因右上腹不适前来我院就诊。检查发现腹部膨隆,触诊显示右季肋部和上腹部有一个大的实性肿块。患者既往病史无特殊,实验室检查正常。超声和计算机断层扫描显示肝脏右叶有一个直径20 cm的大肿瘤。遂行扩大右肝切除术。肿瘤大小为30×28×14 cm,重4725 g。显微镜评估显示为肝脏良性SFT,肿瘤细胞波形蛋白和CD34通常呈阳性。术后病程顺利,患者术后30个月仍存活。这是一种罕见的间叶源性肿瘤,在成年患者中偶尔累及肝脏。大多数SFT是良性的,但有些可能具有恶性组织学特征,可局部复发或转移。由于其罕见性,总体经验有限,关于这种肿瘤的报道很少,包括本病例在内,英文文献中已报道28例。手术是主要的治疗方法。关于这些患者辅助放化疗的益处几乎没有相关报道。由于肝脏SFT通常是良性肿瘤,通常不需要化疗或放疗,应仅用于切除不完全和/或组织学检查显示恶性特征的情况。外科医生必须了解肝脏SFT,这种肿瘤应列入单一肝脏大肿块的鉴别诊断中。

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