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一例直肠腺癌合并肝内胆管癌的病例报告。

A case report of rectal adenocarcinoma with intrahepatic cholangiocarcinoma of the liver.

作者信息

Guo Jing-Qiang, Zou Jing-Jing, Zhu Jin-de, Jiang Chuan, Shao Chu-Xiao

机构信息

Department of Hepatobiliary and Pancreatic Surgery, Lishui Municipal Central Hospital, Lishui City, Zhejiang Province, China.

Emergency Ward, Lishui Municipal Central Hospital, Lishui City, Zhejiang Province, China.

出版信息

J Int Med Res. 2019 Nov;47(11):5883-5890. doi: 10.1177/0300060519876751. Epub 2019 Oct 3.

Abstract

OBJECTIVE

In this case report, we describe our experience with a patient who was treated for rectal adenocarcinoma complicated with primary cholangiocarcinoma of the liver and highlight the problems in the diagnosis and treatment of these potentially fatal lesions.

METHODS

In the clinical setting, we often use the concept of “monism” for diagnosis and treatment. In this report, we review the diagnosis and treatment of rectal adenocarcinoma complicated with primary cholangiocarcinoma of the liver.

RESULTS

Four months after surgery, the patient’s carbohydrate antigen 19-9 level was elevated, and positron emission tomography/computed tomography showed multiple liver metastases. The patient underwent three rounds of transarterial chemoembolisation and two rounds of radiofrequency ablation at our hospital for recurrent hepatocellular carcinoma. The clinical response was poor and indicative of progression of intrahepatic lesions.

CONCLUSION

A preoperative multidisciplinary team, rapid intraoperative pathological examination, and active comprehensive postoperative treatment are necessary to improve the prognosis of multiple primary tumours.

摘要

目的

在本病例报告中,我们描述了一名患有直肠腺癌合并原发性肝胆管癌患者的治疗经历,并强调了这些潜在致命性病变在诊断和治疗中存在的问题。

方法

在临床实践中,我们在诊断和治疗时经常使用“一元论”概念。在本报告中,我们回顾了直肠腺癌合并原发性肝胆管癌的诊断和治疗。

结果

术后四个月,患者的糖类抗原19-9水平升高,正电子发射断层扫描/计算机断层扫描显示多处肝转移。该患者在我院接受了三轮经动脉化疗栓塞和两轮针对复发性肝细胞癌的射频消融治疗。临床反应不佳,提示肝内病变进展。

结论

术前多学科团队、快速术中病理检查以及积极全面的术后治疗对于改善多原发性肿瘤的预后是必要的。

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