Morimoto H, Takada Y, Akita T, Kato Y, Tanigawa N, Muraoka R, Urata Y
Nihon Geka Gakkai Zasshi. 1986 Apr;87(4):456-63.
Primary liver sarcoma is rare and especially its coexistence with hepatocellular carcinoma is extremely rare. We have collected eight cases of their coexistence in the literatures. The patient was a 62-year-old male complaining of right hypochondralgia and general malaise for about one month. CT scanning revealed the liver tumor and right hepatic lobectomy was performed. The tumor was sized in 14 by 9 by 9 cm and composed of hepatocellular carcinoma and rhabdomyosarcoma, which were were collided. Apparent striations in the rhabdomyosarcoma cells was observed under light-microscope. Alphafetoprotein, of which serum level was extraordinarily high, was detected only in hepatocellular carcinoma by special stains. He discharged one month after operation. He was readmitted due to recurrence and received trans-arterial embolisation therapy and systemic chemotherapy. Though transient effect was obtained. He died forty-five days after operation. Autopsy revealed that recurrent liver tumors consisted of only hepatocellular carcinoma and that no other tumorous lesion was found in the other parts of the body. Rhabdomyosarcoma was proved to be primary tumor the liver.
原发性肝肉瘤罕见,尤其是其与肝细胞癌并存极为罕见。我们在文献中收集到8例二者并存的病例。该患者为62岁男性,主诉右季肋部疼痛和全身不适约1个月。CT扫描发现肝脏肿瘤,遂行右肝叶切除术。肿瘤大小为14×9×9cm,由肝细胞癌和横纹肌肉瘤碰撞而成。在光学显微镜下观察到横纹肌肉瘤细胞中有明显的条纹。仅在肝细胞癌中通过特殊染色检测到血清甲胎蛋白水平异常升高。术后1个月出院。因复发再次入院,接受经动脉栓塞治疗和全身化疗。虽取得短暂疗效,但术后45天死亡。尸检显示复发性肝肿瘤仅由肝细胞癌组成,身体其他部位未发现其他肿瘤性病变。横纹肌肉瘤被证实为肝脏原发性肿瘤。