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肝细胞癌术后多发肺转移瘤自发性消退 1 例报告

Spontaneous regression of multiple pulmonary recurrences of hepatocellular carcinoma after hepatectomy: report of a case.

机构信息

Department of Surgery, Iizuka Hospital, 3-83 Yoshio-machi, Iizuka, Fukuoka, 820-8505, Japan.

出版信息

Surg Today. 2012 May;42(5):475-8. doi: 10.1007/s00595-011-0030-7. Epub 2011 Nov 3.

Abstract

Spontaneous regression of hepatocellular carcinoma (HCC) is an extremely rare phenomenon. We herein report the case of a 73-year-old man who showed the spontaneous regression of multiple pulmonary recurrences of HCC that had occurred after hepatectomy. The patient was undergoing dialysis due to diabetic renal failure when ultrasonography revealed a liver tumor (diameter ~ 10 cm). A preoperative diagnosis of HCC with hepatic vein thrombosis was made. The liver function was well preserved and then the right hepatic vein area was resected. Two months after hepatectomy the α-fetoprotein level increased, and multiple lung nodules were observed on follow-up computed tomography. A diagnosis of multiple lung metastases was made, but no therapy was started because of the patient's renal failure. Five months after hepatectomy the α-fetoprotein level normalized, and the metastases regressed completely. The patient is now doing well without any recurrence at 13 months after the surgery. The associated literature on spontaneous HCC regression is also reviewed.

摘要

肝细胞癌(HCC)的自发消退是一种极为罕见的现象。本文报告了 1 例 73 岁男性患者,该患者在肝癌切除术后发生了多次肺复发的自发消退。该患者因糖尿病性肾衰竭而行透析治疗,超声检查发现肝脏肿瘤(直径约 10cm)。术前诊断为伴有肝静脉血栓形成的 HCC,肝功能良好,随后切除了右肝静脉区域。肝切除术后 2 个月,甲胎蛋白水平升高,随访 CT 显示多个肺结节。诊断为多发肺转移,但由于患者肾衰竭,未开始治疗。肝切除术后 5 个月,甲胎蛋白水平恢复正常,转移灶完全消退。术后 13 个月,患者情况良好,无复发。还回顾了与 HCC 自发消退相关的文献。

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