Takeda Haruhiko, Kita Ryuichi, Kanesaka Takashi, Nakajima Jun, Matsuda Fumihiro, Sakamoto Azusa, Hatamaru Keiichi, Saito Sumio, Nasu Akihiro, Nishikawa Hiroki, Komekado Hideyuki, Sekikawa Akira, Tsumura Takehiko, Maruo Takanori, Okabe Yoshihiro, Kimura Toru, Osaki Yukio, Wakasa Tomoko, Nakashima Osamu
Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2013 Sep;110(9):1625-32.
An 85-year-old man with epigastric pain and anorexia was admitted to our hospital. His serum α-fetoprotein (AFP) and protein induced by vitamin K absence or antagonist II (PIVKA II) levels were markedly elevated. Gastrointestinal endoscopy revealed a large mass near the fundus, and computed tomography revealed multiple liver tumors. Intraperitoneal bleeding followed rupture of a liver tumor and was successfully stopped by transarterial embolization; however, regrowth of multiple tumors followed, resulting in liver failure and death within a short period. Autopsy revealed hepatoid adenocarcinomas originating in the stomach that had metastasized to the liver. Hepatoid adenocarcinomas are hypervascular, rapidly growing tumors that may result in the spontaneous rupture of metastatic liver lesions. Transarterial embolization may be a feasible option for the treatment of these ruptured tumors.
一名85岁男性因上腹部疼痛和厌食入住我院。他的血清甲胎蛋白(AFP)和维生素K缺乏或拮抗剂-II诱导蛋白(PIVKA-II)水平显著升高。胃肠内镜检查发现胃底部附近有一个大肿块,计算机断层扫描显示肝脏有多个肿瘤。肝肿瘤破裂后发生腹腔内出血,经动脉栓塞成功止血;然而,随后多个肿瘤复发,导致肝功能衰竭并在短期内死亡。尸检显示胃源性肝样腺癌已转移至肝脏。肝样腺癌是血管丰富、生长迅速的肿瘤,可能导致转移性肝病灶自发性破裂。经动脉栓塞可能是治疗这些破裂肿瘤的一种可行选择。