Departamento de Cirugía General y del Aparato Digestivo.
Departamento de Anatomía Patológica. Hospital Clínico Universitario Lozano Blesa, Zaragoza, España.
Cir Cir. 2021;89(S1):87-92. doi: 10.24875/CIRU.20001310.
Intrabiliary growth of colorectal liver metastasis determines their capability of dissemination and relapse.
65-year-old woman underwent sigmoidectomy (2011) and left hepatectomy due to liver metastases affecting the bile tract (2014). In 2020 she developed a 2cm tumour in the union of both hepatic ducts. Cholangiocarcinoma was suspected so resection of the main bile duct, the caudate lobe and lymphadenectomy were performed. On immunohistochemical examination, colorectal liver metastasis was confirmed.
Liver metastases should be considered as the most likely diagnosis when bile duct dilatation or intrabiliary growth is seen in patients with a history of colorectal cancer.
结直肠肝转移瘤的胆管内生长决定了其扩散和复发的能力。
一位 65 岁女性，因累及胆道的肝转移瘤行乙状结肠癌根治术（2011 年）和左半肝切除术（2014 年）。2020 年，她在左右肝管汇合处发现一个 2cm 的肿瘤。怀疑为胆管癌，因此行胆总管、尾状叶和淋巴结清扫术。免疫组化检查证实为结直肠肝转移瘤。
当有结直肠癌病史的患者出现胆管扩张或胆管内生长时，应考虑肝转移瘤为最可能的诊断。
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