Remiszewski Piotr, Topolewski Paweł, Łaski Dariusz, Drobińska Anna
Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, 80-210 Gdansk, Poland.
J Clin Med. 2024 Jul 23;13(15):4303. doi: 10.3390/jcm13154303.
: Cholangiocarcinoma, the second most common primary liver cancer, is still a contraindication for performing liver transplantation in most patients. Despite various trials being performed in large clinical centers, the results are still not satisfactory. The aim of this study was to present cases from our own cohort and perform a systematic review of the results of liver transplantation in patients with incidental intrahepatic cholangiocarcinoma. : We retrospectively reviewed the records of all patients who underwent liver transplantation and identified two patients with incidental intrahepatic cholangiocarcinoma via histopathological examination of the explanted liver. The results of radiological and biochemical screening performed during liver transplantation, standardized histopathological examination and follow-up data are presented. Additionally, a systematic review of PubMed and Cochrane Reviews based on the PRISMA protocol was performed, yielding 413 similar cases. : We present two cases of incidental intrahepatic cholangiocarcinoma found after liver transplantation. The patients were managed according to a standard protocol with no consecutive modification of immunosuppression or chemotherapy. There was no recurrence or mortality. In this systematic review, the mean reported number of lesions ranged between 1 and 2 per patient. A total of 42 recurrences were reported. The percentage of recurrences ranged between 28.6% and 80%. : Despite not being a frequent finding, follow-up and further treatment of patients with incidental iCCA should be reported and analyzed. Extra carefulness in screening is advised in patients who are already diagnosed with oncological disease of the liver. In long-term follow-up, recurrence of the disease is rather probable.
胆管癌是第二常见的原发性肝癌，在大多数患者中仍是肝移植的禁忌证。尽管大型临床中心开展了各种试验，但结果仍不尽人意。本研究的目的是展示我们自己队列中的病例，并对意外发生的肝内胆管癌患者的肝移植结果进行系统评价。
我们回顾性分析了所有接受肝移植患者的病历，通过对移植肝的组织病理学检查确定了2例意外发生的肝内胆管癌患者。本文展示了肝移植期间进行的影像学和生化筛查结果、标准化组织病理学检查以及随访数据。此外，根据PRISMA方案对PubMed和Cochrane综述进行了系统评价，共得到413例类似病例。
我们展示了2例肝移植后发现的意外肝内胆管癌病例。患者按照标准方案进行管理，未连续调整免疫抑制或化疗方案。未出现复发或死亡情况。在这项系统评价中，报告的每位患者平均病灶数在1至2个之间。共报告了42例复发病例。复发率在28.6%至80%之间。
尽管这并非常见情况，但仍应报告和分析意外发生的肝内胆管癌患者的随访及进一步治疗情况。对于已诊断患有肝脏肿瘤疾病的患者，建议在筛查时格外谨慎。在长期随访中，该病很可能复发。
