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原发性肝类癌;诊断难题:一例病例报告

Primary hepatic carcinoid; a diagnostic dilemma: a case report.

作者信息

Touloumis Zisis, Delis Spiros G, Triantopoulou Charikleia, Giannakou Nikoletta, Avgerinos Costas, Dervenis Christos

机构信息

Liver Surgical Unit, First Department of Surgery, "Agia Olga" General Hospital, 3-5 Agias Olgas street, 14233 N, Ionia, Athens, Greece.

出版信息

Cases J. 2008 Nov 17;1(1):314. doi: 10.1186/1757-1626-1-314.

Abstract

INTRODUCTION

Primary hepatic carcinoid tumours (PHCTs) are extremely rare neuroendocrine neoplasms. Only 58 cases have been reported in the literature and less than 10 cases were functional.

CASE PRESENTATION

We present a case of a 65 years old, Caucasian female with a large unresectable primary hepatic carcinoid tumor secreting 5-hydroxyindoleacetic acid (5-HIAA), presented with flushing and diarrhoea and treated with trans-catheter arterial embolization (TACE) and subsequent administration of lanreotide (long acting somatostatin analogue).

CONCLUSION

The diagnosis of PHCTs is difficult due to their common radiologic characteristics with other liver lesions. Their diagnosis is based on the exclusion of other sites of disease and the histologic confirmation. Although the mainstay of treatment when is technically feasible is surgical resection with optimal 5-year survival and low recurrence rate, in cases of unresectable disease palliation with combination of TACE and administration of somatostatin analogues have good results in controlling the disease and the patients symptoms.

摘要

引言

原发性肝类癌肿瘤(PHCTs)是极其罕见的神经内分泌肿瘤。文献中仅报道了58例,其中功能性病例少于10例。

病例报告

我们报告一例65岁的白种女性,患有一个无法切除的原发性肝类癌大肿瘤,分泌5-羟吲哚乙酸(5-HIAA),表现为面部潮红和腹泻,接受了经导管动脉栓塞术(TACE)治疗,随后给予兰瑞肽(长效生长抑素类似物)。

结论

由于PHCTs与其他肝脏病变具有共同的放射学特征,其诊断较为困难。其诊断基于排除其他疾病部位并经组织学证实。尽管在技术可行时,主要治疗方法是手术切除,5年生存率最佳且复发率低,但在无法切除的疾病病例中,TACE与生长抑素类似物联合应用的姑息治疗在控制疾病和患者症状方面有良好效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b95f/2596793/8a6c9799a7ab/1757-1626-1-314-1.jpg

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