Cmarková Kristína, Nosakova Lenka, Pindura Miroslav, Kyčina Roman, Marcinek Juraj, Miklušica Juraj
Department of General, Visceral, and Transplant Surgery, Martin University Hospital, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava (JFM CU), Martin, Slovakia.
Department of Internal Medicine - Gastroenterology, Martin University Hospital, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava (JFM CU), Martin, Slovakia.
Am J Case Rep. 2025 May 7;26:e946739. doi: 10.12659/AJCR.946739.
BACKGROUND Multiple primary malignancies in a single patient are considered to be quite rare. However, due to the wider availability of advanced imaging methods and, more regular check-ups, they are becoming more common in clinical practice. To determine the diagnosis of multiple primary malignancies, each tumor must be completely separate and cannot be from metastasis of one or the other. Coexisting hepatocellular carcinoma and gallbladder carcinoma are extremely rare, with only a few case reports published. We believe that to determine the most effective therapeutic management, the results of as many cases as possible should be documented. Regardless of limited data, curative resection may be the most beneficial treatment option in terms of overall survival. CASE REPORT We present the case of a 64-year-old man first diagnosed with hepatocellular carcinoma with possible infiltration of the gallbladder wall as appeared on a CT scan. However, the definitive histopathologic examination revealed the coexistence of hepatocellular carcinoma and gallbladder carcinoma. In this case report, we offer an insight into the entire diagnostic process, as well as the chosen surgical approach and adjuvant therapy. Moreover, we present our approach to preoperative biopsy, the decision-making process throughout the whole diagnostic and therapeutic course, and the achieved results. CONCLUSIONS In cases of double primary malignancies, the choice of therapeutic strategy depends on the type and stage of both malignancies, but procedures with curative intent are superior. We present the outcome and overall survival of the patient after the surgery and adjuvant chemotherapy for synchronous hepatocellular carcinoma and gallbladder carcinoma. Since the liver is the organ most commonly affected by metastatic dissemination of primary tumors, exclusion of metastatic disease is particularly important.
背景 单个患者发生多种原发性恶性肿瘤被认为相当罕见。然而,由于先进成像方法的广泛应用以及更频繁的体检,它们在临床实践中变得越来越常见。为了确定多种原发性恶性肿瘤的诊断,每个肿瘤必须完全独立,不能是另一个肿瘤的转移灶。肝细胞癌和胆囊癌同时存在极为罕见,仅有少数病例报告发表。我们认为,为了确定最有效的治疗方案,应记录尽可能多病例的结果。尽管数据有限,但就总生存期而言,根治性切除可能是最有益的治疗选择。病例报告 我们报告一例64岁男性患者,最初经CT扫描诊断为肝细胞癌,可能侵犯胆囊壁。然而,最终的组织病理学检查显示肝细胞癌和胆囊癌并存。在本病例报告中,我们深入探讨了整个诊断过程、所选择的手术方法和辅助治疗。此外,我们介绍了术前活检方法、整个诊断和治疗过程中的决策过程以及所取得的结果。结论 在双原发性恶性肿瘤病例中,治疗策略的选择取决于两种恶性肿瘤的类型和分期,但具有治愈意图的手术更为优越。我们介绍了该患者同步性肝细胞癌和胆囊癌手术后及辅助化疗后的结局和总生存期。由于肝脏是最常受原发性肿瘤转移扩散影响的器官,排除转移性疾病尤为重要。