经皮孤立性肝灌注治疗门静脉癌栓的肝细胞癌后病理完全缓解：一例报告

Pathological complete response after percutaneous isolated hepatic perfusion in hepatocellular carcinoma with portal vein tumor thrombosis: a case report.

作者信息

Arai Keisuke, Fukumoto Takumi, Tanaka Motofumi, Kuramitsu Kaori, Kido Masahiro, Kinoshita Hisoka, Matsumoto Taku, Toyama Hirochika, Asari Sadaki, Goto Tadahiro, Ajiki Tetsuo, Ku Yonson

机构信息

Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Graduate School of Medicine,, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.

出版信息

Surg Case Rep. 2016 Dec;2(1):50. doi: 10.1186/s40792-016-0178-x. Epub 2016 May 26.

BACKGROUND

Although the effectiveness of perioperative adjuvant therapy in the treatment of hepatocellular carcinoma (HCC) has been investigated, the efficacy of preoperative therapy is unclear. Herein, we report a case of pathological complete response after percutaneous isolated hepatic perfusion (PIHP) for HCC involving portal vein tumor thrombosis (PVTT).

CASE PRESENTATION

A 77-year-old woman was referred to our institute with a liver mass detected on a routine health screening. Computed tomography revealed a 28 × 25 mm HCC in the left lobe of the liver and a tumor thrombus in the left and right portal branches (T4N0M0, stage IVA). The patient received a single dose of preoperative PIHP with doxorubicin plus mitomycin C, without severe toxicity. After the chemotherapy, she underwent extended left hepatic lobectomy and thrombectomy of the PVTT. No cancer cells were detected during histopathological analysis, indicating pathological complete response. She remained relapse-free 12 months after the surgery.

CONCLUSIONS

We experienced a case of pathological complete response after preoperative PIHP with doxorubicin plus mitomycin C for HCC involving PVTT.

背景

尽管已经对围手术期辅助治疗在肝细胞癌（HCC）治疗中的有效性进行了研究，但术前治疗的疗效尚不清楚。在此，我们报告1例经皮肝隔离灌注（PIHP）治疗累及门静脉癌栓（PVTT）的HCC后出现病理完全缓解的病例。

病例介绍

一名77岁女性因在常规健康筛查中发现肝脏肿块转诊至我院。计算机断层扫描显示肝左叶有一个28×25mm的HCC，左右门静脉分支有肿瘤血栓（T4N0M0，IVA期）。该患者接受了单剂量术前PIHP联合阿霉素和丝裂霉素C治疗，无严重毒性反应。化疗后，她接受了扩大左肝叶切除术和PVTT取栓术。组织病理学分析未检测到癌细胞，表明病理完全缓解。术后12个月她仍无复发。