Hanaoka Jun, Shimada Mitsuo, Ikegami Toru, Imura Satoru, Morine Yuji, Kanemura Hirofumi, Arakawa Yusuke, Kurita Nobuhiro, Utsunomiya Toru, Miyake Hidenori
Department of Surgery, The University of Tokushima, Tokushima 770-8503, Japan.
Hepatogastroenterology. 2008 Nov-Dec;55(88):2217-20.
A clinicopathological analysis of a case with long-term survival after surgical resection for hepatocellular carcinoma (HCC) with massive bile duct tumor thrombus (BDTT) is presented. A 73-year-old female, who was hepatitis C antibody-positive, was referred to our hospital for jaundice. She had a history of small HCC in segment 4 of the liver, which was treated by percutaneous ethanol injection therapy 5 years previously. Contrast-enhanced magnetic resonance imaging detected the primary tumor in segment 4, and a BDTT in the common bile duct with dilatation of the intrahepatic bile duct. Percutaneous transhepatic cholangiography revealed a defect from the bilateral hepatic ducts to the middle part of the common bile duct. Left lobectomy of the liver with thrombectomy and local bile duct resection was performed. The patient has remained alive with no sign of recurrence for 5 years since the surgery. Here, we describe this case of HCC with BDTT showing long-term survival and the usefulness of curative surgical resection with removal of the tumor thrombus.
本文介绍了一例肝细胞癌（HCC）伴大量胆管肿瘤血栓（BDTT）手术切除后长期存活的病例的临床病理分析。一名73岁丙型肝炎抗体阳性的女性因黄疸被转诊至我院。她有肝4段小肝癌病史，5年前接受过经皮乙醇注射治疗。对比增强磁共振成像检测到肝4段的原发性肿瘤，以及胆总管内的BDTT伴肝内胆管扩张。经皮肝穿刺胆管造影显示从双侧肝管到胆总管中部有缺损。行肝左叶切除、血栓清除术和局部胆管切除术。自手术以来，患者已存活5年，无复发迹象。在此，我们描述了这例伴BDTT的HCC病例，其显示出长期存活以及手术切除肿瘤血栓的根治性手术的有效性。
