Mimatsu Kenji, Oida Takatsugu, Kawasaki Atsushi, Aramaki Osamu, Kuboi Youichi, Katsura Yoshihisa, Amano Sadao
Department of Surgery, Social Insurance Yokohama Central Hospital, 268 Yamashita-cho, Naka-ku, Yokohama, Kanagawa, Japan.
Int J Clin Oncol. 2008 Aug;13(4):365-8. doi: 10.1007/s10147-007-0747-x. Epub 2008 Aug 15.
Bile duct hamartomas, also known as von Meyenburg complexes, are benign neoplasms consisting of cystic dilatation of the bile duct surrounded by fibrous stroma. We report a rare case in a 60-year-old man who presented with coexistent von Meyenburg complex and esophageal carcinoma. Preoperative computed tomography did not reveal any liver tumors. Intraoperatively, a small lesion was discovered in segment III of the liver; the lesion was suspected to be a solitary liver metastasis from the esophageal carcinoma. Partial resection of the liver was performed, and pathological findings revealed bile duct hamartoma (von Meyenburg complex). As von Meyenburg complexes are small cystic lesions located throughout the liver, and as they do not present characteristic imaging findings, their preoperative morphological diagnosis and differential diagnosis from liver metastasis is extremely difficult. In conclusion, von Meyenburg complex should be considered in the differential diagnosis of intrahepatic cystic neoplasms.
胆管错构瘤,也称为冯·迈恩伯格复合体,是由被纤维基质包绕的胆管囊性扩张构成的良性肿瘤。我们报告一例罕见病例,一名60岁男性同时患有冯·迈恩伯格复合体和食管癌。术前计算机断层扫描未发现任何肝脏肿瘤。术中,在肝脏Ⅲ段发现一个小病灶;该病灶怀疑是食管癌的孤立性肝转移灶。行肝脏部分切除术,病理结果显示为胆管错构瘤(冯·迈恩伯格复合体)。由于冯·迈恩伯格复合体是遍布肝脏的小囊性病灶,且不具有特征性影像学表现,因此术前对其进行形态学诊断并与肝转移瘤进行鉴别诊断极为困难。总之,在肝内囊性肿瘤的鉴别诊断中应考虑冯·迈恩伯格复合体。