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肝脏原发性黏液性胆管癌切除术标本

Resected primary mucinous cholangiocarcinoma of the liver.

作者信息

Hagiwara Kei, Araki Kenichiro, Yamanaka Takahiro, Ishii Norihiro, Igarashi Takamichi, Watanabe Akira, Kubo Norio, Harimoto Norifumi, Kuwano Hiroyuki, Nobusawa Sumito, Aishima Shinichi, Shirabe Ken

机构信息

Hepatobiliary and Pancreatic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, 371-8511, Japan.

General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.

出版信息

Surg Case Rep. 2018 May 2;4(1):41. doi: 10.1186/s40792-018-0450-3.

Abstract

BACKGROUND

Mucinous cholangiocarcinoma (MC) is a very rare variant of intrahepatic cholangiocarcinoma. MC is characterized by rapid growth, widespread metastasis, and poor prognosis. We report a case of resected MC of the liver.

CASE PRESENTATION

We found a 13.6-cm hypovascular tumor in the left hepatic lobe of a 68-year-old man, which we initially diagnosed as a mass-forming intrahepatic cholangiocarcinoma. Left lobe and caudate resection was performed without major intraoperative or postoperative complications. He was discharged home on postoperative day 9 and had no recurrence for 6 months. Pathological examination showed a mucous lobulated tumor with abundant mucus in the cytoplasm and extracellular regions. After differential diagnosis that considered invasive intraductal papillary neoplasm of the bile duct and metastatic liver tumors from the digestive tract, this tumor was diagnosed as a cholangiocarcinoma rare variant: primary mucinous carcinoma of the liver.

CONCLUSION

Analysis of previous reports suggests that primary MC of the liver could be classified into two subtypes: pure MC and combined hepatocellular carcinoma and MC. Notably, the latter has been reported only in patients with chronic liver disease, whereas the former has only been reported in patients with no underlying disease.

摘要

背景

黏液性胆管癌(MC)是肝内胆管癌一种非常罕见的变异类型。MC的特点是生长迅速、广泛转移且预后较差。我们报告一例肝脏黏液性胆管癌切除病例。

病例介绍

我们在一名68岁男性的左肝叶发现一个13.6厘米的乏血供肿瘤,最初诊断为肿块型肝内胆管癌。行左叶及尾状叶切除,术中及术后均无严重并发症。他术后第9天出院,6个月无复发。病理检查显示为黏液性分叶状肿瘤,细胞质和细胞外区域有大量黏液。在鉴别诊断考虑胆管浸润性导管内乳头状肿瘤和消化道肝转移瘤后,该肿瘤被诊断为胆管癌罕见变异型:原发性肝黏液癌。

结论

对既往报道的分析表明,原发性肝脏MC可分为两个亚型:纯MC和肝细胞癌合并MC。值得注意的是,后者仅在慢性肝病患者中报道,而前者仅在无基础疾病的患者中报道。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8ac/5931950/ada4d7998f7c/40792_2018_450_Fig1_HTML.jpg

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