Kasai Y, Sasaki E, Tamaki A, Koshino I, Kawanishi N
Jpn J Surg. 1977 Jun;7(2):65-72. doi: 10.1007/BF02469388.
A generally recognized concept dictates that surgical intervention for non-parasitic cysts of the liver is mostly palliative such as aspiration of the content, suture and closure, internal or external drainage, marsupialization, and unroofing of the cyst, while total excision of the entire cyst, which sometimes necessitates hepatic resection, is not usually recommended.3, 6, 9 The results of these lesser procedures have been acceptable, favoring those conservative procedures. This paper presents three cases with carcinoma arising in the cysts of the liver. Review of the present cases with five comparable cases appearing in the literature revealed that young female population and left lobe of the liver are frequently involved. Hence the general trend for palliative procedures should be reassessed. Possible malignancy should be considered when a patient belongs to this category, the cystic content is not clear, or the cystic wall presents irregular texture with nodules. The carcinomatous changes would have been of higher incidence than reported if the entire cysts had been more carefully examined.
一个普遍认可的概念认为,对于非寄生虫性肝囊肿的手术干预大多是姑息性的,如抽吸内容物、缝合与闭合、内引流或外引流、袋形缝合以及囊肿开窗术,而通常不建议对整个囊肿进行完全切除,有时这需要进行肝切除。3、6、9这些较小手术的结果是可以接受的,更倾向于那些保守手术。本文介绍了3例肝囊肿发生癌变的病例。回顾目前的病例以及文献中出现的5例类似病例发现,年轻女性人群和肝左叶经常受累。因此,应重新评估姑息手术的总体趋势。当患者属于此类、囊肿内容物不明确或囊肿壁呈现不规则质地并伴有结节时,应考虑可能存在恶性肿瘤。如果对整个囊肿进行更仔细的检查,癌变的发生率可能会高于报道的水平。