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肝脏血管周上皮样细胞肿瘤的管理:一例报告及文献复习

Management of perivascular epithelioid cell tumor of the liver: A case report and review of the literature.

作者信息

Liu Daren, Shi Dike, Xu Yuanliang, Cao Liping

机构信息

Department of Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, Hangzhou 310009, P.R. China.

出版信息

Oncol Lett. 2014 Jan;7(1):148-152. doi: 10.3892/ol.2013.1689. Epub 2013 Nov 19.

Abstract

Perivascular epithelioid cell tumor (PEComa) is a rare tumor that originates from mesenchymal tissues. Cases of PEComa in the liver are extremely rare. The present study aimed to analyze the clinical features of PEComa in the liver and discuss its management. Here we report a 25-year-old female with multiple lesions of low density with poorly defined borders in the liver, as shown by a computed tomography (CT) scan. A partial hepatectomy was proceeded and PEComa was diagnosed by immunohistochemistry. No evidence of recurrence was observed during the one year follow-up. A total of 20 patients with hepatic PEComa, including one case from the present study and 19 cases that were reported in literature between June 2001 and December 2012, were reviewed and analyzed. The mean patient age was 43.4 years (range, 25-67 years) and the cases consisted of 18 female and two male patients. The tumor size ranged between 2.0×1.6 and 15.0×12.0 cm. Of the 20 patients, nine were asymptomatic and 11 had mild to significant complaints. Immunohistochemistry plays a key role in the diagnosis of PEComa. All the cases in this study were strongly positive for human melanoma black-45. A surgical resection is the gold standard for curative intent. All the patients underwent a surgical resection and none were administered perioperative chemotherapy or radiotherapy. In total, 13 of the 14 patients with follow-up information survived during the 8-36-month follow-up period and one patient succumbed due to recurrence two years after the surgery.

摘要

血管周上皮样细胞肿瘤(PEComa)是一种起源于间叶组织的罕见肿瘤。肝脏PEComa病例极为罕见。本研究旨在分析肝脏PEComa的临床特征并探讨其治疗方法。在此,我们报告一名25岁女性,计算机断层扫描(CT)显示其肝脏有多个边界不清的低密度病灶。进行了部分肝切除术,免疫组化诊断为PEComa。在一年的随访期间未观察到复发迹象。回顾并分析了总共20例肝脏PEComa患者,包括本研究中的1例以及2001年6月至2012年12月期间文献报道的19例。患者平均年龄为43.4岁(范围25 - 67岁),其中18例为女性患者,2例为男性患者。肿瘤大小在2.0×1.6至15.0×12.0 cm之间。20例患者中,9例无症状,11例有轻度至重度不适。免疫组化在PEComa的诊断中起关键作用。本研究中所有病例人黑色素瘤黑色45均呈强阳性。手术切除是根治性治疗的金标准。所有患者均接受了手术切除治疗,且均未接受围手术期化疗或放疗。在有随访信息的14例患者中,共有13例患者在8 - 36个月的随访期内存活,1例患者在术后两年因复发死亡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d648/3861588/0d0388b26307/OL-07-01-0148-g00.jpg

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