Moga Doru-Florian-Cornel, Gavrilă Gabriela-Ariadna, Dan Andreea-Alina, Smarandache Cătălin-Gabriel
Clinical Department of Surgery, Military Clinical Emergency Hospital Sibiu and Lucian Blaga University Sibiu, Romania.
Medical Analysis Laboratory, Military Clinical Emergency Hospital Sibiu and Lucian Blaga University Sibiu, Romania.
Int J Surg Case Rep. 2024 Apr;117:109580. doi: 10.1016/j.ijscr.2024.109580. Epub 2024 Mar 24.
Spontaneous tumor regression is an extremely rare phenomenon in the oncology field.
We present the case of a 72-years-old male patient presenting with a bulky hepatic tumor mass located in segment V and extending into segments IVb and VI with MRI features of atypical cholangiocarcinoma with a liver metastasis in segment III. In first surgical step, excision of the metastasis, and ligation of the right portal vein was done. A new MRI examination performed 5 weeks later shows significant tumor regression, and 2 weeks later, during the second surgery, the tumor was not found. Under these conditions we performed a limited segment V liver resection, in the area indicated by the radiologist as the site of the tumor. No viable malignant cells existed in the tumor specimen, and a third MRI examination didn't identify any residual tumor.
From our literature study this is the only case of complete tumor regression of an intrahepatic cholangiocarcinoma following portal vein ligation. We believe the portal vein ligation resulted in a marked regression/deficiency in the tumor blood supply.
Serial MRI examinations demonstrated the regression of intrahepatic cholangiocarcinoma after portal vein ligation. Intrahepatic cholangiocarcinoma should be included in the tumors that could extremely rarely spontaneously regress.
肿瘤自发消退在肿瘤学领域是一种极为罕见的现象。
我们报告一例72岁男性患者，其肝脏有一个巨大肿瘤肿块，位于Ⅴ段，延伸至Ⅳb段和Ⅵ段，磁共振成像（MRI）表现为非典型胆管癌，伴有Ⅲ段肝转移。在首次手术中，切除了转移灶，并结扎了右门静脉。5周后进行的新MRI检查显示肿瘤明显消退，2周后，在第二次手术时未发现肿瘤。在此情况下，我们在放射科医生指示的肿瘤部位进行了有限的Ⅴ段肝切除术。肿瘤标本中未发现存活的恶性细胞，第三次MRI检查未发现任何残留肿瘤。
根据我们的文献研究，这是门静脉结扎术后肝内胆管癌完全消退的唯一病例。我们认为门静脉结扎导致肿瘤血供显著减少/缺乏。
系列MRI检查显示门静脉结扎后肝内胆管癌消退。肝内胆管癌应纳入极少会自发消退的肿瘤之列。
