Tomino Takahiro, Yamashita Yo-Ichi, Iguchi Tomohiro, Itoh Shinji, Ninomiya Mizuki, Ikegami Toru, Yoshizumi Tomoharu, Soejima Yuji, Kawanaka Hirofumi, Ikeda Tetsuo, Aishima Shinichi, Shirabe Ken, Maehara Yoshihiko
Department of Surgery and Science, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Case Rep Gastroenterol. 2014 Apr 24;8(1):148-55. doi: 10.1159/000362440. eCollection 2014 Jan.
We herein present the case of a 77-year-old man who had fever and right hypochondriac pain. He visited his doctor and underwent contrast computed tomography (CT), and he was suspected to have a liver abscess. He received an antibiotic treatment and his symptoms soon disappeared, but the tumor did not get smaller and its density on contrast CT image got stronger. He underwent biopsy and moderately differentiated hepatocellular carcinoma (HCC) was found. Extended left hepatic and caudate lobectomy was performed. Histological examination showed moderately differentiated HCC with narrowing and occlusion both in the arteries and portal veins associated with mild chronic inflammation. The mechanisms of spontaneous regression of HCC, such as immunological reactions and tumor hypoxia, have been proposed. In our case, histological examination showed the same findings. However, the mechanism is complex, and therefore further investigations are essential to elucidate it.
我们在此报告一例77岁男性患者，该患者有发热及右季肋部疼痛。他前往就医并接受了增强计算机断层扫描（CT），怀疑患有肝脓肿。他接受了抗生素治疗，症状很快消失，但肿瘤并未缩小，增强CT图像上其密度增强。他接受了活检，结果发现为中度分化肝细胞癌（HCC）。遂行扩大左肝及尾状叶切除术。组织学检查显示为中度分化HCC，伴有动脉和门静脉狭窄及闭塞，并伴有轻度慢性炎症。已经提出了HCC自发消退的机制，如免疫反应和肿瘤缺氧。在我们的病例中，组织学检查显示了相同的结果。然而，其机制复杂，因此进一步研究对于阐明该机制至关重要。
