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肝血管平滑肌瘤的临床分析:两例报告

Clinical analysis of hepatic angioleiomyoma: Two case reports.

作者信息

Jiang Bin, Chen Qiu-Ni, Qi Fu-Zhen, Xu Jian-Bo, Yu Ya-Bin, Song Yan

机构信息

Department of Hepatobiliary and Pancreatic Surgery.

Department of Hematology, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, Huai'an, Jiangsu Province, PR China.

出版信息

Medicine (Baltimore). 2019 Mar;98(11):e14661. doi: 10.1097/MD.0000000000014661.

Abstract

RATIONALE

Angioleiomyoma is an uncommon benign tumor that originates from the vascular smooth muscle cells and contains thick-walled vessels. It can appear anywhere in the body but more frequently in the extremities (especially in the lower limbs) and rarely invades the internal organs.

PATIENT CONCERNS

A 52-year-old Chinese woman was referred to our hospital because of finding liver neoplasm 2 weeks ago (case first) and a 64-year-old Chinese woman was admitted to hospital with enlargement of the hepatic neoplasm revealed in follow-up, who was diagnosed with angioleiomyoma of left kidney 2 years ago (case second).

DIAGNOSIS

All patients were diagnosed with hepatic angioleiomyoma by pathological results.

INTERVENTIONS

All patients received surgical treatment, with laparoscopic hepatectomy of the IVb segment in case 1 and laparoscopic hepatic left lateral lobectomy in case 2.

OUTCOMES

The 2 patients have eventually recovered, and no recurrences or other complications have been observed so far.

LESSONS

Because of atypical clinical symptoms, no specificity in laboratory examination, and lack of characteristic imaging findings, angioleiomyoma is easily misdiagnosed for another disease of the liver. But with complete resection, the prognosis is generally good.

摘要

理论依据

血管平滑肌瘤是一种罕见的良性肿瘤,起源于血管平滑肌细胞,含有厚壁血管。它可出现在身体的任何部位,但更常见于四肢(尤其是下肢),很少侵犯内脏器官。

患者情况

一名52岁的中国女性因两周前发现肝脏肿瘤(病例一)被转诊至我院,另一名64岁的中国女性因随访中发现肝脏肿瘤增大入院,她两年前被诊断为左肾血管平滑肌瘤(病例二)。

诊断

所有患者经病理结果确诊为肝脏血管平滑肌瘤。

干预措施

所有患者均接受了手术治疗,病例一为IVb段腹腔镜肝切除术,病例二为腹腔镜肝左外叶切除术。

结果

两名患者最终康复,目前未观察到复发或其他并发症。

经验教训

由于血管平滑肌瘤临床症状不典型,实验室检查无特异性,且缺乏特征性影像学表现,易被误诊为肝脏的其他疾病。但通过完整切除,预后一般良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c398/6426533/2e95e0a82cfc/medi-98-e14661-g001.jpg

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