Quante Michael, Appenrodt Beate, Randerath Simone, Wolff Martin, Fischer Hans-Peter, Sauerbruch Tilman
Department of Medicine I, University Hospital Bonn, Germany.
Scand J Gastroenterol. 2009;44(1):116-20. doi: 10.1080/00365520802028858.
A 55-year-old woman with suspected hilar cholangiocarcinoma presented with jaundice and dilated intrahepatic bile ducts owing to high-grade hepatic duct confluence stenosis. The suspected tumour and the entire extrahepatic bile duct system were resected and Roux-en-Y hepaticojejunostomy was performed. Histological investigations showed perihepatic fibrosis but no signs of malignancy. One year later the patient developed bilateral hydronephrosis caused by ureteral obstruction. Since the patient had a gynaecological history of widespread inflammation, she was referred for transabdominal operative ureterolysis combined with hysterectomy and adnexectomy. Histological investigations as well as fluorodeoxyglucose-positron emission tomography (FDG-PET) and computed tomography (CT) findings were compatible with retroperitoneal fibrosis (Ormond's disease). Treatment with tamoxifen was initiated. To the best of our knowledge, only a few cases of intraperitoneal fibroses mimicking cholangiocarcinoma followed by the typical symptoms of retroperitoneal Ormond's disease have been reported.
一名55岁疑似肝门部胆管癌的女性患者，因肝门部胆管汇合处高度狭窄出现黄疸和肝内胆管扩张。切除疑似肿瘤及整个肝外胆管系统，并进行了Roux-en-Y肝空肠吻合术。组织学检查显示肝周纤维化，但无恶性迹象。一年后，患者因输尿管梗阻出现双侧肾积水。由于该患者有广泛炎症的妇科病史，遂转诊接受经腹手术性输尿管松解术，同时行子宫切除术和附件切除术。组织学检查以及氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）和计算机断层扫描（CT）结果均符合腹膜后纤维化（奥蒙德病）。开始用他莫昔芬治疗。据我们所知，仅有少数模仿胆管癌的腹膜内纤维化继以典型腹膜后奥蒙德病症状的病例报道。
