Gao Jun, Zhang Qingshuai, Zhang Jun, Kong Jian, Wang Shaohong, Ding Xuemei, Ke Shan, Sun Wenbing
Department of Hepatobiliary Surgery, Beijing Chao-yang Hospital Affiliated to Capital Medical University, Beijing, China.
Medicine (Baltimore). 2015 Jul;94(27):e1122. doi: 10.1097/MD.0000000000001122.
Hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT) formation is a rare entity found microscopically in 1% to 9.2% of resected specimens. The ideal treatment for HCC is surgical resection. However, because of poor hepatic functional reserve in patients with HCC, most tumors are unresectable. Here, we report 2 cases of HCC with BDTT type III accompanied by hepatic dysfunction that were successfully treated with radiofrequency (RF) ablation. We used RF ablation as both a radical therapeutic method and an efficient way to control bleeding from the origin of BDTT after BDTT removal. At the time of writing, the 2 patients have been disease-free for 16 and 12 months, respectively.Our results show that RF ablation may be used as a radical therapeutic alternative for HCC with BDTT in patients with liver cirrhosis and obstructive jaundice.
伴有胆管瘤栓(BDTT)形成的肝细胞癌(HCC)是一种罕见实体,在1%至9.2%的切除标本中可通过显微镜检查发现。HCC的理想治疗方法是手术切除。然而,由于HCC患者肝功能储备较差,大多数肿瘤无法切除。在此,我们报告2例伴有肝功能障碍的III型BDTT HCC患者,经射频(RF)消融治疗成功。我们将RF消融既用作根治性治疗方法,又用作在去除BDTT后控制BDTT起源处出血的有效方法。在撰写本文时,这2例患者分别已无病生存16个月和12个月。我们的结果表明,RF消融可作为肝硬化和梗阻性黄疸患者伴有BDTT的HCC的一种根治性治疗替代方法。