原发性硬化性胆管炎和溃疡性结肠炎患者的肝内胆管癌：两例病例报告。
Intrahepatic cholangiocarcinoma in patients with primary sclerosing cholangitis and ulcerative colitis: Two case reports.
作者信息
Miyazu Takahiro, Ishida Natsuki, Asai Yusuke, Tamura Satoshi, Tani Shinya, Yamade Mihoko, Iwaizumi Moriya, Hamaya Yasushi, Osawa Satoshi, Baba Satoshi, Sugimoto Ken
机构信息
First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan.
Department of Endoscopic and Photodynamic Medicine, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan.
出版信息
World J Gastrointest Surg. 2023 Jun 27;15(6):1224-1231. doi: 10.4240/wjgs.v15.i6.1224.
BACKGROUND
Primary sclerosing cholangitis (PSC) is an extraintestinal manifestation of ulcerative colitis (UC). PSC is a well-known risk factor for intrahepatic cholangiocarcinoma (ICC), and ICC is known to have a poor prognosis.
CASE SUMMARY
We present two cases of ICC in patients with PSC associated with UC. In the first case, a tumor was found by magnetic resonance imaging (MRI) in the liver of a patient with PSC and UC who presented to our hospital with right-sided rib pain. The second patient was asymptomatic, but we unexpectedly detected two liver tumors in an MRI performed to evaluate bile duct stenosis associated with PSC. ICC was strongly suspected by computed tomography and MRI in both cases, and surgery was performed, but unfortunately, the first patient died of ICC recurrence 16 mo postoperatively, and the second patient died of liver failure 14 mo postoperatively.
CONCLUSION
Careful follow-up of patients with UC and PSC with imaging and blood tests is necessary for early detection of ICC.
背景
原发性硬化性胆管炎（PSC）是溃疡性结肠炎（UC）的一种肠外表现。PSC是肝内胆管癌（ICC）的一个众所周知的危险因素，并且已知ICC预后较差。
病例摘要
我们报告了2例与UC相关的PSC患者发生ICC的病例。第一例，一名患有PSC和UC的患者因右侧肋骨疼痛前来我院就诊，通过磁共振成像（MRI）在其肝脏中发现了一个肿瘤。第二例患者无症状，但在为评估与PSC相关的胆管狭窄而进行的MRI检查中，我们意外地在其肝脏中检测到两个肿瘤。两例病例通过计算机断层扫描和MRI均高度怀疑为ICC，并进行了手术，但不幸的是，第一例患者术后16个月死于ICC复发，第二例患者术后14个月死于肝功能衰竭。
结论
对UC和PSC患者进行仔细的影像学和血液检查随访对于早期发现ICC很有必要。
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