Hirosawa Takuya, Morimoto Naoki, Miura Kouichi, Ono Kohei, Watanabe Shunji, Fujieda Takeshi, Murayama Kozue, Takaoka Yoshinari, Nomoto Hiroaki, Tsukui Mamiko, Isoda Norio, Niki Toshiro, Tokushige Katsutoshi, Yamamoto Hironori
Division of Gastroenterology, Department of Medicine, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
Division of Integrative Pathology, Department of Pathology, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
Clin J Gastroenterol. 2019 Jun;12(3):223-230. doi: 10.1007/s12328-018-00932-0. Epub 2019 Jan 7.
Congenital hepatic fibrosis (CHF), a fibropolycystic disease, is characterized by bile duct malformation, periportal fibrosis, and renal polycystic disease. Although cholangiocellular carcinoma is the primary tumor arising from fibropolycystic diseases, hepatocellular carcinoma (HCC) is extremely rare. In addition, no algorism for determining the optimum HCC treatment has yet been available in cases of fibropolycystic disease due to variations in the background liver and renal conditions. We herein report a patient with HCC arising from CHF that was successfully treated using radiofrequency ablation (RFA) under laparoscopic assistance. A 37-year-old man with CHF was admitted to our hospital for treatment of HCC in 2014. Imaging revealed HCC located in hepatic segments II and VIII with diameters of 28 and 24 mm, respectively. There had been no histories of recurrent cholangitis or renal failure after when CHF was diagnosed in 2003. In addition, esophageal varices were well controlled. We achieved sufficient ablation using a bipolar ablation system without any complications. The post-operative course was uneventful, and the patient was free from HCC for 4 years. Thus, locoregional therapy, including RFA, is acceptable for the treatment of HCC arising from CHF when the background liver and kidney are preserved.
先天性肝纤维化(CHF)是一种纤维多囊性疾病,其特征为胆管畸形、门周纤维化和肾多囊性疾病。虽然胆管细胞癌是纤维多囊性疾病引发的主要肿瘤,但肝细胞癌(HCC)极为罕见。此外,由于背景肝脏和肾脏状况各异,在纤维多囊性疾病患者中,尚无确定最佳HCC治疗方案的算法。我们在此报告1例由CHF引发HCC的患者,该患者在腹腔镜辅助下通过射频消融(RFA)成功治愈。一名患有CHF的37岁男性于2014年因HCC入院接受治疗。影像学检查显示HCC位于肝段Ⅱ和Ⅷ,直径分别为28和24毫米。自2003年诊断出CHF后,无复发性胆管炎或肾衰竭病史。此外,食管静脉曲张得到良好控制。我们使用双极消融系统实现了充分消融,且无任何并发症。术后病程平稳,患者4年内未出现HCC。因此,当背景肝脏和肾脏功能得以保留时,包括RFA在内的局部治疗可用于治疗由CHF引发的HCC。