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肝脏恶性孤立性纤维性肿瘤。

Malignant solitary fibrous tumor involving the liver.

机构信息

Department of Surgery, Spitalzentrum Biel AG, CH-2501 Biel, Switzerland.

出版信息

World J Gastroenterol. 2013 Jun 7;19(21):3354-7. doi: 10.3748/wjg.v19.i21.3354.

Abstract

Solitary fibrous tumors are predominantly benign and are most commonly found in the thoracic cavity and pleura; while reports exist in the literature of malignant solitary fibrous tumors and those located in extrathoracic organs, these cases are considered extremely rare. Herein, a case is reported of a malignant solitary fibrous tumor involving the liver that was diagnosed and treated in a 62-year-old woman. The patient presented with complaints of upper abdominal pain and unintentional weight loss. Computed tomography scan of the abdomen revealed a remarkably large mass, measuring 15 cm × 10 cm × 20 cm, which appeared to be unrelated to any particular organ. The intraoperative finding of a wide communication with the left liver suggested hepatic origin, and served as an indicator for tumor resection via left hemihepatectomy. The diagnosis of solitary fibrous tumor and its malignant nature was confirmed by histological and immunohistochemical examination of the resected tissues. Hepatic solitary fibrous tumor is very rare, and surgery remains the mainstay of treatment. Due to limited reports of such tumors in the literature, little can be said about the benefit of adjuvant therapy and prognosis for the rare cases with malignant histological findings.

摘要

孤立性纤维瘤主要为良性,最常见于胸腔和胸膜;虽然文献中有恶性孤立性纤维瘤和发生于胸外器官的报道,但这些病例极为罕见。本文报道了一例发生于肝脏的恶性孤立性纤维瘤,该肿瘤发生于一名 62 岁女性,经诊断和治疗后确诊。患者以上腹部疼痛和非自愿性体重减轻为主要症状。腹部计算机断层扫描显示一个明显大的肿块,大小为 15cm×10cm×20cm,似乎与任何特定器官无关。术中发现与左肝广泛相通,提示来源于肝脏,并通过左半肝切除术进行肿瘤切除。通过对切除组织的组织学和免疫组织化学检查,确诊为孤立性纤维瘤及其恶性性质。肝孤立性纤维瘤非常罕见,手术仍然是主要的治疗方法。由于文献中此类肿瘤的报道有限,对于罕见的具有恶性组织学发现的病例,辅助治疗和预后的益处几乎无法说明。

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