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肝脏原发性外生性骨外骨肉瘤:一例报告及文献复习

Primary Exophytic Extraskeletal Osteosarcoma of the Liver: A Case Report and Literature Review.

作者信息

Zhang Jing, He Xiuchao, Yu Wenying, Ying Fuming, Cai Jun, Deng Shengde

机构信息

Department of Imaging Center, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang Province, 315000, People's Republic of China.

Ningbo Diagnostic Pathology Center, Ningbo, Zhejiang Province, 315000, People's Republic of China.

出版信息

Risk Manag Healthc Policy. 2021 Mar 11;14:1009-1014. doi: 10.2147/RMHP.S296172. eCollection 2021.

Abstract

INTRODUCTION

Primary hepatic extraskeletal osteosarcoma (ESOS) is a rare tumor with no specific clinical manifestations, and little is known about it. Here, we describe an elderly patient with primary hepatic osteosarcoma confirmed by pathology results to raise awareness.

CASE REPORT

We report an unusual case of a 62-year-old man who presented with right upper quadrant pain. The inflammatory indicators were elevated, and alkaline phosphatase (AKP), carbohydrate antigen (CA-199 and CA-125) were slightly increased. Computed tomography images and magnetic resonance images discovered a 7.8 × 7.4 × 6.6 cm mass with irregular radiated and cotton-like tumor bone between the liver and right kidney space. Pathology revealed the mass to be primary exophytic ESOS of the liver. The patient underwent a surgical operation and standard chemotherapy and is still alive with no recurrence and metastasis to date.

CONCLUSION

Owing to the rarity of the tumor and the lack of clinical characteristics and specific laboratory indexes, it is difficult to make a correct diagnosis. Medical imaging features mainly behave soft tissue entity with tumor bone composition. Surgical resection combined with adjuvant chemotherapy is the main treatment for ESOS.

摘要

引言

原发性肝外骨肉瘤(ESOS)是一种罕见的肿瘤,没有特定的临床表现,人们对其了解甚少。在此,我们描述一例经病理结果证实的原发性肝骨肉瘤老年患者,以提高认识。

病例报告

我们报告一例不寻常的病例,一名62岁男性,表现为右上腹疼痛。炎症指标升高,碱性磷酸酶(AKP)、糖类抗原(CA-199和CA-125)略有升高。计算机断层扫描图像和磁共振图像显示,在肝右肾间隙有一个7.8×7.4×6.6 cm的肿块,伴有不规则放射状和棉絮状肿瘤骨。病理显示该肿块为肝脏原发性外生性ESOS。患者接受了手术和标准化化疗,至今仍存活,无复发和转移。

结论

由于该肿瘤罕见,缺乏临床特征和特异性实验室指标,难以做出正确诊断。医学影像特征主要表现为含有肿瘤骨成分的软组织实体。手术切除联合辅助化疗是ESOS的主要治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d7f/7961132/337bf6d750ce/RMHP-14-1009-g0001.jpg

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