Wu Yuzhe, Wang Weimin, Shu Bin, Li Min, Xu Jianjun, Zheng Qichang
Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan 430022, China.
Department of Hepatobiliary and Pancreatic Surgery, Beijing Tsinghua Changgung Hospital Beijing 102218, China.
Int J Clin Exp Pathol. 2020 May 1;13(5):1206-1211. eCollection 2020.
Intrahepatic cholangiocarcinoma is the second most common primary malignancy of liver with poor prognosis. Four patients of intrahepatic cholangiocarcinoma were diagnosed after several years' observation with hepatic hemangioma in recent reports. Herein, we present a rare case of much longer surveillance of intrahepatic cholangiocarcinoma diagnosed after 20 years follow up for hepatic hemangioma. An asymptomatic 74-year old Chinese man was admitted to our hospital for a recent enlarged liver mass lesion, after 20 years follow-up for hepatic hemangioma. He was first diagnosed with a hemangioma in segment 8 of liver by abdominal ultrasound in February 1994, on basis of slightly hyperechoic feature with 1.6 × 1.1 cm in size. The mass lesion has enlarged markedly since 2013, which was confirmed by ultrasonography, computed tomography, magnetic resonance imaging, and positron emission tomography. Thus, hepatectomy was performed and histological characteristic revealed that the mass lesion was intrahepatic cholangiocarcinoma. This is the longest disease course of intrahepatic cholangiocarcinoma ever reported, which may change the former understanding of the biological behavior of intrahepatic cholangiocarcinoma and is worthy of further study.
肝内胆管癌是肝脏第二常见的原发性恶性肿瘤，预后较差。近期报道中，有4例肝内胆管癌患者在被诊断为肝血管瘤并经过数年观察后确诊。在此，我们报告1例极为罕见的病例，该患者在对肝血管瘤进行20年随访后确诊为肝内胆管癌，其监测时间更长。一名无症状的74岁中国男性因近期肝脏肿块增大入住我院，其肝血管瘤已随访20年。1994年2月，他首次经腹部超声检查诊断为肝脏8段血管瘤，表现为略高回声特征，大小为1.6×1.1厘米。自2013年以来，该肿块明显增大，经超声、计算机断层扫描、磁共振成像和正电子发射断层扫描得以证实。因此，实施了肝切除术，组织学特征显示该肿块为肝内胆管癌。这是有报道以来肝内胆管癌最长的病程，可能会改变以往对肝内胆管癌生物学行为的认识，值得进一步研究。
