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特纳综合征患者的炎性肝细胞腺瘤:一例报告。

Inflammatory hepatocellular adenoma in a patient with Turner's syndrome: A case report.

作者信息

Nemoto Satoshi, Ariizumi Shun-Ichi, Kotera Yoshihito, Omori Akiko, Yamashita Shingo, Kato Taka-Aki, Aoyama Shota, Egawa Hiroto, Yamamoto Masakazu

机构信息

Department of Gastroenterology Surgery, Tokyo Women's Medical University, Japan.

Department of Gastroenterology Surgery, Tokyo Women's Medical University, Japan.

出版信息

Int J Surg Case Rep. 2019;56:5-9. doi: 10.1016/j.ijscr.2019.02.017. Epub 2019 Feb 15.

Abstract

INTRODUCTION

Hepatocellular adenoma (HCA) is a rare benign tumor and is related to the use of an oral contraceptive pill. Turner's syndrome requires various hormone replacement therapies, including the pill which is used as a female hormone replacement therapy. Herein we report a case of Turner's syndrome with HCA treated by liver segmentectomy.

PRESENTATION OF CASE

A 36-year-old woman with Turner's syndrome was treated with oral contraceptive pills as a female hormone replacement therapy for 20 years. She presented with fatigue and liver tumor. Liver tumors in the posterior lobe measuring 60 mm and 10 mm in diameter were detected on CT; hence, she was referred to our department. Both the tumors showed high intensity in the arterial phase, iso-intensity in the portal and late phases, and low intensity in the hepatobiliary phase on Gb-EOB-MRI. She was diagnosed with multiple HCAs and underwent segmentectomy Section 7. Pathologically, both the tumors were diagnosed as HCAs, and inflammatory markers were detected by immunohistochemistry. Thirteen months postoperatively, she was doing well and there was no evidence of recurrence of HCA without the pill.

DISCUSSION

There is only one report of HCA in patients with TS (Espat et al., 2000). We reported a case of multiple HCAs in a patient with TS underwent hepatectomy.

CONCLUSION

With the use of the contraceptive pill as a long-term female hormone replacement therapy for Turner's syndrome, careful attention is required for HCA.

摘要

引言

肝细胞腺瘤(HCA)是一种罕见的良性肿瘤,与口服避孕药的使用有关。特纳综合征需要多种激素替代疗法,包括用作女性激素替代疗法的避孕药。在此,我们报告一例经肝段切除术治疗的特纳综合征合并HCA病例。

病例介绍

一名36岁的特纳综合征女性接受口服避孕药作为女性激素替代疗法治疗20年。她出现疲劳和肝脏肿瘤。CT检查发现肝后叶有直径分别为60毫米和10毫米的肝脏肿瘤;因此,她被转诊至我科。在钆塞酸二钠增强磁共振成像(Gb-EOB-MRI)上,两个肿瘤在动脉期均表现为高信号,门静脉期和延迟期为等信号,肝胆期为低信号。她被诊断为多发性HCA,并接受了第7段肝段切除术。病理检查显示,两个肿瘤均被诊断为HCA,免疫组化检测到炎症标志物。术后13个月,她情况良好,停用避孕药后无HCA复发迹象。

讨论

仅有一篇关于特纳综合征患者发生HCA的报道(埃斯帕特等人,2000年)。我们报告了一例特纳综合征患者发生多发性HCA并接受肝切除术的病例。

结论

对于将避孕药用作特纳综合征长期女性激素替代疗法的情况,需要密切关注HCA。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ada/6389595/bfbde38eb927/gr1.jpg

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