Boonsinsukh Thana, Viriyaroj Vichit, Rookkachart Thammanij, Trongwongsa Therdkiat
Department of Surgery, Faculty of Medicine, Srinakharinwirot University, Ongkharak, Nakhon Nayok, Thailand.
Department of Pathology, Faculty of Medicine, Srinakharinwirot University, Ongkharak, Nakhon Nayok, Thailand.
Case Rep Surg. 2018 Jan 9;2018:3862575. doi: 10.1155/2018/3862575. eCollection 2018.
The authors report a case of a patient with intrahepatic sarcomatous cholangiocarcinoma. A 45-year-old Thai man presented with a 3-month history of right upper abdominal pain. CT scan revealed hepatomegaly with a 6.5 cm hypovascular soft tissue density mass in the right lobe and showed mild delayed enhancement. On exploratory laparotomy, the tumor adherent to right diaphragm was found. We performed right hepatectomy, partial resection of right diaphragm, and cholecystectomy. The immunohistological results suggested "sarcomatous intrahepatic cholangiocarcinoma." The tumor was recurrent in 5 months after operation and unresectable. Therefore, the treatment in this patient was supportive care. He died 11 months after his initial presentation. The literature reviews showed that intrahepatic sarcomatous cholangiocarcinoma is aggressive malignant with poor prognosis. Early detection, radical resection, and careful follow-up would be the treatment for the favorable prognosis.
作者报告了一例肝内肉瘤样胆管癌患者。一名45岁的泰国男性，有3个月右上腹疼痛病史。CT扫描显示肝脏肿大，右叶有一个6.5厘米的低血供软组织密度肿块，呈轻度延迟强化。在剖腹探查术中，发现肿瘤与右膈膜粘连。我们进行了右肝切除术、右膈膜部分切除术和胆囊切除术。免疫组织学结果提示为“肝内肉瘤样胆管癌”。肿瘤在术后5个月复发且无法切除。因此，该患者接受了支持性治疗。他在首次就诊后11个月死亡。文献综述表明，肝内肉瘤样胆管癌是一种侵袭性恶性肿瘤，预后较差。早期发现、根治性切除和密切随访是获得良好预后的治疗方法。
