Mukai Yosuke, Wada Hiroshi, Eguchi Hidetoshi, Yamada Daisaku, Asaoka Tadafumi, Noda Takehiro, Kawamoto Koichi, Gotoh Kunihito, Takeda Yutaka, Tanemura Masahiro, Umeshita Koji, Hori Yumiko, Morii Eiichi, Doki Yuichiro, Mori Masaki
Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2-E2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
Department of Surgery, Kansai Rosai Hospital, Osaka, Japan.
Surg Case Rep. 2016 Dec;2(1):29. doi: 10.1186/s40792-016-0156-3. Epub 2016 Mar 23.
The incidence of hepatobiliary malignancies, and especially intrahepatic cholangiocarcinoma (ICC), for patients with Wilson's disease (WD), is very low, even for cirrhotic patients. A 44-year-old male was admitted to our department for treatment of a liver tumor. He was diagnosed with WD at the age of 15. According to radiological findings, his liver tumor was a suspected hepatocellular carcinoma (HCC) or a combined hepatocellular and cholangiocellular carcinoma. A partial resection of liver segments 8 (S8) and 5 (S5) was subsequently performed due to the intraoperative suspicion of intrahepatic metastasis at the surface of S5. Postoperative histology revealed that the resected portion of S8 contained an ICC; the removed S5 portion comprised a regenerative nodule with hemosiderosis. To date, the patient has survived without tumor recurrence for more than 44 months following surgery. A survey of the literature, inclusive of case reports, would suggest that surgical resection is the primary course of action for a WD patient with ICC, if liver function can be preserved and curative resection performed.
威尔逊病(WD)患者发生肝胆恶性肿瘤,尤其是肝内胆管癌(ICC)的发生率非常低,即使是肝硬化患者也是如此。一名44岁男性因肝脏肿瘤入院接受治疗。他15岁时被诊断为WD。根据影像学检查结果,他的肝脏肿瘤疑似为肝细胞癌(HCC)或肝细胞胆管细胞混合癌。由于术中怀疑S5表面存在肝内转移,随后对肝段8(S8)和5(S5)进行了部分肝切除术。术后组织学检查显示,切除的S8部分包含一个ICC;切除的S5部分为含铁血黄素沉着的再生结节。迄今为止,该患者术后已存活超过44个月,无肿瘤复发。对包括病例报告在内的文献进行的一项调查表明,如果能够保留肝功能并进行根治性切除,手术切除是WD合并ICC患者的主要治疗方法。