Gong Yong-Qiang, Lu Tai-Liang, Chen Chao-Wu
Department of Gastrointestinal Surgery, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha 410005, Hunan Province, China.
Department of Gastrointestinal Surgery, Hunan Provincial People's Hospital, Changsha 410005, Hunan Province, China.
World J Gastrointest Surg. 2023 Aug 27;15(8):1819-1824. doi: 10.4240/wjgs.v15.i8.1819.
Hepatocellular carcinoma (HCC) is a highly malignant cancer that often metastasizes and has a poor prognosis. Gastrointestinal tract metastases are rare, and colon metastases are even rarer. The long-term survival of patients with multiple intrahepatic and extrahepatic metastases, especially to the colon, has not been previously reported.
We present an atypical clinical case of a patient with liver, right lung, peritoneal, and colon metastases diagnosed successively following hepatic resection for primary HCC. Comprehensive treatment, including partial liver, lung and colon resection, palliative management such as systemic chemotherapy, trans-arterial chemoembolization, targeted therapy with sorafenib, and cryotherapy were attempted. Despite his early metastases, the patient remained relatively healthy for 8 years after diagnosis.
This case indicates that comprehensive treatment is beneficial for certain patients with metastatic HCC. Clinicians should be alert as to the possibility of rare site metastatic tumors that may be easily misdiagnosed as primary tumors.
肝细胞癌(HCC)是一种高度恶性的癌症,常发生转移且预后较差。胃肠道转移罕见,结肠转移更为罕见。此前尚未报道过伴有肝内和肝外多处转移,尤其是转移至结肠的患者的长期生存情况。
我们报告了一例非典型临床病例,该患者因原发性肝癌行肝切除术后相继被诊断出肝、右肺、腹膜和结肠转移。尝试了包括部分肝、肺和结肠切除在内的综合治疗,以及全身化疗、经动脉化疗栓塞、索拉非尼靶向治疗和冷冻治疗等姑息治疗措施。尽管患者早期发生转移,但诊断后8年仍相对健康。
该病例表明综合治疗对某些转移性肝癌患者有益。临床医生应警惕罕见部位转移瘤的可能性,这些转移瘤可能容易被误诊为原发性肿瘤。