肝内胆管细胞癌合并多发胆管腺瘤被误诊为胰腺神经内分泌肿瘤肝转移。

Intrahepatic Cholangiocarcinoma Coexisting With Multiple Bile Duct Adenoma Treated as Liver Metastasis from a Pancreatic Neuroendocrine Tumor.

机构信息

Department of Surgery, Yamaga City Medical Center, Kumamoto, Japan.

Department of Radiology, Yamaga City Medical Center, Kumamoto, Japan.

出版信息

Anticancer Res. 2021 Oct;41(10):5249-5254. doi: 10.21873/anticanres.15344.

DOI:10.21873/anticanres.15344

PMID:34593478

Abstract

BACKGROUND

Bile duct adenomas (BDA) may be precursor lesions of small duct-type, including mass-forming type intrahepatic cholangiocarcinoma (ICC).

CASE REPORT

A 68-year-old woman was transferred to our facility for the treatment of a liver tumor, possibly metastasized from a pancreatic neuroendocrine tumor. Finally, two liver tumors were resected and histopathologically diagnosed as "BDA" and "ICC with a BDA-like component". In the BDA-like component, the MUC6 positive rate was notably lower and the Ki-67 positive rate was higher than the other BDAs and ICC component, respectively. The doubling time of the tumor volume in BDA was very long but was shortened (1,510 and 719 days). Distinct enlargement of the tumor and appearance of enhancement through diagnostic imaging was useful in diagnosing the transformation from a BDA to an ICC.

CONCLUSION

An "adenoma-carcinoma sequence" may exist in the transformation process from a BDA to an ICC.

摘要

背景

胆管腺瘤（BDA）可能是小胆管型的前体病变，包括形成肿块型的肝内胆管癌（ICC）。

病例报告

一名 68 岁女性因疑似来源于胰腺神经内分泌瘤的肝转移瘤而转入我院治疗。最终，切除了两个肝肿瘤，组织病理学诊断为“BDA”和“具有 BDA 样成分的 ICC”。在 BDA 样成分中，MUC6 阳性率明显较低，Ki-67 阳性率分别高于其他 BDA 和 ICC 成分。BDA 肿瘤体积的倍增时间很长，但缩短了（1510 和 719 天）。肿瘤的明显增大和通过诊断性影像学出现增强的表现有助于诊断从 BDA 向 ICC 的转化。