Alcalde M, Garcia-Diaz M, Pecellin J, Pijierro A, Sanchez P, Soria R, de Santamaria J S
Gastroenterology Department, Infanta Cristina University Hospital, University of Extremadura, Carretera de Portugal, Badajoz, Spain.
Acta Gastroenterol Belg. 1996 Apr-Jun;59(2):163-5.
We report one case of urothelial carcinoma with diffuse intrasinusoidal metastasis to the liver and clinical presentation mimicking fulminant hepatic failure. The patient was a 69-year-old man admitted to the hospital for upper gastrointestinal hemorrhage. Two years previously he had undergone a right nephrectomy for urothelial carcinoma (T2, GII). After five days of hospital admission, he developed progressive jaundice, ascites, deteriorating mental status with high serum enzyme activities (AST, ALT, LDH, alkaline phosphatase) and death 20 days after hospitalization. No grossly detectable hepatic metastatic nodules were demonstrated. A percutaneous postmortem liver biopsy revealed a diffuse infiltration of tumor cells into the hepatic sinusoids and venous invasion.
我们报告一例膀胱尿路上皮癌，其肝脏出现弥漫性窦内转移，临床表现类似暴发性肝衰竭。患者为一名69岁男性，因上消化道出血入院。两年前，他因膀胱尿路上皮癌（T2，GII）接受了右肾切除术。入院五天后，他出现进行性黄疸、腹水，精神状态恶化，血清酶活性（AST、ALT、LDH、碱性磷酸酶）升高，并于住院20天后死亡。未发现明显可检测到的肝脏转移结节。经皮肝穿刺尸检活检显示肿瘤细胞弥漫浸润肝血窦并侵犯静脉。
