Kitagawa Dai, Taketomi Akinobu, Aishima Shinichi, Kuroda Yosuke, Gion Tomonobu, Shirabe Ken, Shimada Mitsuo, Maehara Yoshihiko
Department of Surgery and Medical Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan.
Hepatogastroenterology. 2008 May-Jun;55(84):1085-8.
This paper reports a rare case of intrahepatic cholangiocarcinoma (ICC) which recurred nine years after surgical resection. The patient underwent right hepatic trisegmentectomy with lymph node dissection and biliary tract reconstruction for a tumor in the right lobe of the liver. The patient was diagnosed with ICC, intraductal growth (IG) type. Nine years after the operation a rise of tumor markers and a recurrent lesion in the remnant liver were recognized and the patient underwent S2 subsegmentectomy with tumor thrombectomy and biliary tract reconstruction. The resected specimen showed well differentiated adenocarcinoma, which consisted of chiefly intraductal growth component. The patient is still alive 26 months after the second operation without recurrence. It is important to observe the patient carefully cosidering that it is possible for an IG type cholangiocarcinoma to recur a long time after surgical treatment, and surgical treatment for the recurrent tumor should be tried for long survival.
本文报道了一例罕见的肝内胆管癌（ICC）病例，该病例在手术切除九年后复发。患者因肝右叶肿瘤接受了右半肝三叶切除术、淋巴结清扫术和胆道重建术。患者被诊断为ICC，导管内生长（IG）型。术后九年，肿瘤标志物升高，残余肝脏出现复发病灶，患者接受了S2亚段切除术、肿瘤血栓切除术和胆道重建术。切除标本显示为高分化腺癌，主要由导管内生长成分组成。二次手术后26个月，患者仍然存活，无复发。鉴于IG型胆管癌在手术治疗后可能长时间复发，仔细观察患者很重要，对于复发性肿瘤应尝试手术治疗以延长生存期。
