Ratia Giménez T, Domínguez Franjo P, Mugüerza Huguet J M, Enríquez Navascues J M, Lasa Unzúe I, Díez Alonso M, Granell Vicent J
Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid.
Rev Esp Enferm Dig. 1996 May;88(5):373-7.
Nowadays incidental focal hepatic lesions are detected rather frequently by abdominal imaging. A 12 cm diameter liver mass was incidentally found in an abdominal ultrasound in a 26 years old man. Despite an extensive diagnostic workup, the diagnosis of hepatocellular carcinoma could only be attained through the histological study of the surgical specimen. Differential diagnosis of a focal hepatic lesion is reviewed. Radiological assessment and biopsy procedures should follow a protocol. Where doubt exists about the presence of malignancy after fulfilling the diagnostic protocol we believe that it is justified to remove the lesion. This policy allowed to treat successfully our patient. Hepatocellular carcinoma in noncirrhotic occurs much less frequently than in cirrhotic liver, and moreover, it is specially rare to find at such a young age a non fibrolamellar hepatocarcinoma non associated with cirrhosis or a chronic viral infection. Diagnosis, treatment and prognosis of hepatocellular carcinoma are reviewed.
如今，腹部成像检查相当频繁地发现肝脏偶发局灶性病变。一名26岁男性在腹部超声检查中偶然发现一个直径12厘米的肝脏肿块。尽管进行了广泛的诊断检查，但肝细胞癌的诊断只能通过手术标本的组织学研究来确定。本文回顾了肝脏局灶性病变的鉴别诊断。放射学评估和活检程序应遵循一定的方案。在完成诊断方案后，如果对恶性肿瘤的存在仍有疑问，我们认为切除病变是合理的。这一策略使我们的患者得到了成功治疗。非肝硬化性肝细胞癌的发生率远低于肝硬化肝脏中的发生率，此外，在如此年轻的患者中发现非纤维板层型肝细胞癌且与肝硬化或慢性病毒感染无关的情况尤为罕见。本文还回顾了肝细胞癌的诊断、治疗和预后。
