Maeda Takashi, Hashimoto Koji, Ishida Teruyoshi, Yamashita Yo-Ichi, Saeki Hiroshi, Kawanaka Hirofumi, Uchiyama Hideaki, Ikeda Tetsuo, Tsujitani Shunichi, Maehara Yoshihiko
Fukuoka Igaku Zasshi. 2013 Dec;104(12):564-8.
A 68-year-old man underwent a partial resection of the liver and lymph node dissection for a tumor, 3.0 cm in diameter, in S4 of the liver under the diagnosis of cholangiocellular carcinoma (CCC). The histological diagnosis was cholangiolocellular carcinoma (CoCC) and lymphatic permeation and venous invasion were recognized. Seven months after surgery, CT demonstrated two recurrent nodules in S7 and S8 of the liver, then a partial resection of the liver was performed. The gross and pathological findings were the same as the previously resected tumor. Four months after the second operation, CT demonstrated dilated intrahepatic bile ducts and lymph node swelling of the hepatic hilum. The patient died of disease thirteen months after the first operation. On the basis of the clinical and pathological features of this case, we consider that CoCC clinically resembles CCC and prognosis may be unfavorable, although it has characteristic pathological findings. It is still controversial whether CoCC should be accepted as a separate entity. The significance of repeat hepatectomy for recurrence and adjuvant chemotherapy should be clarified to improve the prognosis of CoCC.
一名68岁男性因肝脏S4区直径3.0 cm的肿瘤，在胆管细胞癌（CCC）诊断下行肝部分切除术及淋巴结清扫术。组织学诊断为胆管细胞性肝癌（CoCC），可见淋巴管浸润和静脉侵犯。术后7个月，CT显示肝脏S7和S8有两个复发结节，随后行肝部分切除术。大体和病理表现与先前切除的肿瘤相同。第二次手术后4个月，CT显示肝内胆管扩张及肝门淋巴结肿大。患者在第一次手术后13个月死于疾病。基于该病例的临床和病理特征，我们认为CoCC在临床上类似于CCC，尽管它有特征性的病理表现，但其预后可能不佳。CoCC是否应被视为一个独立的实体仍存在争议。应明确重复肝切除术对复发的意义及辅助化疗，以改善CoCC的预后。
