Zhou Di, Quan Zhiwei, Wang Jiandong
Department of General Surgery, XinHua Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
Intractable Rare Dis Res. 2018 May;7(2):112-119. doi: 10.5582/irdr.2018.01052.
Primary and secondary intrahepatic malignant mesothelioma (PIHMM & SIHMM) caused by Peritoneal mesothelioma (PM) are extremely rare tumors and their clinicopathological characteristics remain unclear. The current study presented a case of a 63-year-old female with PIHMM and a literature review of Chinese case reports of SIHMM and PIHMM was performed. The patient received curative left hemihepatectomy because of a 5.5 × 5.0 × 4.0 cm mass occupying the II, III and the lateral portion of the IV segments and meanwhile tightly infiltrating the diaphragm (yellow arrow) was also observed. The pathological diagnosis was epithelial type PIHMM. Immunohistochemistry revealed that the tumor was positive for Calretinin, CK5/6, WT-1 and D2-40(N). The literature review included 11 studies and 6 case reports with a total of 293 PM patients accompanied with 31 SIHMM cases and then 3 case reports of PIHMM. SIHMM and PIHMM are extremely rare, easy to misdiagnose malignant tumors. Immunohistochemistry should be performed strictly in accordance with guidelines, which is crucial for pathological diagnosis. Comprehensive treatment of surgery combined with chemotherapy are mainstream methods for SIHMM and PIHMM. Also, exact survival data should be carefully explored so that objective evaluation of the efficacy of the treatment could be achieved.
由腹膜间皮瘤(PM)引起的原发性和继发性肝内恶性间皮瘤(PIHMM和SIHMM)是极其罕见的肿瘤,其临床病理特征仍不清楚。本研究报告了1例63岁患有PIHMM的女性病例,并对SIHMM和PIHMM的中文病例报告进行了文献综述。该患者因一个5.5×5.0×4.0 cm的肿块占据肝Ⅱ、Ⅲ段及Ⅳ段外侧部分而接受了根治性左半肝切除术,同时还观察到肿块紧密浸润膈肌(黄色箭头)。病理诊断为上皮型PIHMM。免疫组织化学显示肿瘤Calretinin、CK5/6、WT-1和D2-40(N)呈阳性。文献综述包括11项研究和6例病例报告,共有293例PM患者伴有31例SIHMM病例,以及3例PIHMM病例报告。SIHMM和PIHMM是极其罕见、容易误诊的恶性肿瘤。免疫组织化学应严格按照指南进行,这对病理诊断至关重要。手术联合化疗的综合治疗是SIHMM和PIHMM的主流治疗方法。此外,应仔细探究确切的生存数据,以便能够对治疗效果进行客观评估。