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成人对成人活体肝移植治疗肝脏转移性恶性黑色素瘤。

Adult-to-adult living donor liver transplantation for malignant metastatic melanoma to the liver.

机构信息

Department of Liver and Vascular Surgery, West China Hospital, Sichuan University, Chengdu, China.

出版信息

Hepatobiliary Pancreat Dis Int. 2010 Jun;9(3):329-32.

Abstract

BACKGROUND

Metastases from malignant melanoma to the liver are rare in China, and surgical resection may be of potential benefit. Liver transplantation for this disease has never been reported.

METHODS

We report a case of adult-to-adult living donor liver transplantation (A-A LDLT) for metastatic melanoma. With a surgical history of ocular melanoma, the recipient presented with emaciation from a large right hepatic mass which also probably had portal vein invasion. A-A LDLT was successfully performed and no postoperative complications were observed in either the donor or the recipient. Postoperative pathology confirmed the diagnosis of metastatic malignant melanoma; however no adjuvant chemotherapy was employed after transplantation. We also reviewed the literature on the surgical treatment of metastatic malignant melanoma to the liver and discussed the LDLT indications.

RESULT

Recurrence occurred 6 months after surgery and the patient died from recurrence of the disease 8 months post-transplant.

CONCLUSIONS

Review of the literature suggested that only a small subset of selected patients may benefit from liver resection. Large metastatic disease in the liver potentially involving a major vessel, as in this case, should be contraindicated for liver transplantation.

摘要

背景

在中国,恶性黑色素瘤转移至肝脏的情况较为罕见,而手术切除可能具有潜在益处。针对该疾病,肝移植尚未见报道。

方法

我们报告了一例成人对成人活体肝移植(A-A LDLT)治疗转移性黑色素瘤的病例。该患者有眼部黑色素瘤的手术史,表现为消瘦,右侧肝巨大占位,可能侵犯门静脉。成功实施了 A-A LDLT,供体和受体均未出现术后并发症。术后病理证实为转移性恶性黑色素瘤;但移植后未进行辅助化疗。我们还回顾了文献中关于肝转移恶性黑色素瘤的手术治疗,并讨论了 LDLT 的适应证。

结果

术后 6 个月复发,移植后 8 个月患者死于疾病复发。

结论

文献复习表明,只有一小部分选定的患者可能从肝切除中获益。如本例中肝内有大量转移病灶,且可能累及大血管,应禁忌肝移植。

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