Feng Ji-Ye, Li Xian-Peng, Wu Zong-Yang, Ying Li-Ping, Xin Chang, Dai Zhen-Zhen, Shen Yao, Wu Yi-Feng
Department of Hepatobiliary & Pancreas Surgery, The Affiliated People's Hospital of Ningbo University, Ningbo 315040, Zhejiang Province, China.
Department of Infectious Disease, The Affiliated People's Hospital of Ningbo University, Ningbo 315040, Zhejiang Province, China.
World J Clin Cases. 2022 Mar 26;10(9):2829-2835. doi: 10.12998/wjcc.v10.i9.2829.
Sarcomatoid intrahepatic cholangiocarcinoma (SICC) is an extremely rare and highly invasive malignant tumor of the liver. The precise pathologic mechanism of SICC has not been clearly identified, and the prognosis is very poor. The effectiveness of the treatment strategy of radical hepatectomy combined with Huaier granules has not yet been reported.
The patient was a 69-year-old male who presented with intermittent right upper abdominal pain for one month and 4-pound weight loss before admission. Abdominal magnetic resonance imaging and magnetic resonance cholangiopancreatography showed multiple stones in the bile ducts accompanied by dilatation of the intrahepatic and extrahepatic bile ducts. The preoperative diagnoses were right intrahepatic bile duct stones and extrahepatic bile duct stones; thus, surgical resection was performed. Choledochoscopy showed that the bile duct wall of the right anterior lobe was thickened, and a mass was visible in the duct. Then, a biopsy was performed, and rapid frozen-section biopsy analysis indicated that the tumor was malignant. The final diagnosis was SICC (T1aN0M0). Huaier granules were taken by the patient as anticancer therapy after surgery. The patient attended follow-up for 72 mo with no tumor recurrence or metastasis.
Sarcomatous intrahepatic cholangiocarcinoma is an extremely rare, aggressive malignancy, and the diagnostic gold standard is pathological diagnosis. We reported the first case of successful treatment with Huaier granules as anticancer therapy after surgery, which indicated that Huaier granules are safe and effective. Further studies are needed to study the anticancer molecular mechanisms of Huaier granules in sarcomatous intrahepatic cholangiocarcinoma.
肉瘤样肝内胆管癌(SICC)是一种极其罕见且具有高度侵袭性的肝脏恶性肿瘤。SICC的确切病理机制尚未明确,预后很差。根治性肝切除术联合槐耳颗粒的治疗策略的有效性尚未见报道。
患者为69岁男性,入院前出现右上腹间断性疼痛1个月,体重减轻4磅。腹部磁共振成像和磁共振胰胆管造影显示胆管内多发结石,伴有肝内和肝外胆管扩张。术前诊断为右肝内胆管结石和肝外胆管结石;因此,进行了手术切除。胆管镜检查显示右前叶胆管壁增厚,管腔内可见肿物。随后进行了活检,快速冰冻切片活检分析表明肿瘤为恶性。最终诊断为SICC(T1aN0M0)。患者术后服用槐耳颗粒作为抗癌治疗。患者随访72个月,无肿瘤复发或转移。
肉瘤样肝内胆管癌是一种极其罕见、侵袭性强的恶性肿瘤,诊断金标准是病理诊断。我们报道了首例术后使用槐耳颗粒作为抗癌治疗成功的病例,这表明槐耳颗粒安全有效。需要进一步研究槐耳颗粒在肉瘤样肝内胆管癌中的抗癌分子机制。