Shimada M, Kajiyama K, Saitoh A, Kano T
Department of Surgery, National Fukuoka-Higashi Hospital, Kasuya, Japan.
Hepatogastroenterology. 1996 Jan-Feb;43(7):249-54.
We herein present two cases with cystic neoplasms of the liver, both successfully treated by a surgical resection. One patient underwent a tumor enucleation, while the other had a left hepatic lobectomy and left caudate lobectomy. Although the follow-up period is still relatively short, both patients are doing well without any sign of recurrence. The specimens were histopathologically examined including immunohistochemical staining. Both tumors were unilocular-cystic and contained mucus. One tumor was considered to have originated from a cystadenoma with a mesenchymal stroma, which has been espoused by Wheeler and Edmondson, while the other tumor was considered to have originated from the bile duct. Therefore, the diagnosis of one patient was cystadenocarcinoma, while the other was considered to be a mucin-producing papillary adenocarcinoma of the intrahepatic bile duct. No invasive growth to the liver parenchyma or the surrounding tissues was observed in either case. Thus, a surgical resection should be the first choice of treatment for cystic neoplasms of the liver. Furthermore, a malignant transformation of cystadenoma with a mesenchymal stroma should be given a special entity in cystadenocarcinoma.
我们在此报告两例肝囊性肿瘤患者，均通过手术切除成功治愈。一例患者接受了肿瘤剜除术，另一例则进行了左肝叶切除术和左尾状叶切除术。尽管随访期仍相对较短，但两名患者情况良好，均无复发迹象。对标本进行了组织病理学检查，包括免疫组化染色。两个肿瘤均为单房性囊肿，含有黏液。一个肿瘤被认为起源于具有间叶性间质的囊腺瘤，这一观点已得到惠勒和埃德蒙森的支持，而另一个肿瘤被认为起源于胆管。因此，一名患者的诊断为囊腺癌，而另一名患者被认为是肝内胆管黏液性乳头状腺癌。在这两种情况下，均未观察到肿瘤向肝实质或周围组织的浸润性生长。因此，手术切除应是肝囊性肿瘤的首选治疗方法。此外，具有间叶性间质的囊腺瘤的恶性转化应在囊腺癌中作为一种特殊类型。
