Mueller J, Keeffe E B, Esquivel C O
Department of Transplantation, California Pacific Medical Center, San Francisco 94115, USA.
Liver Transpl Surg. 1995 Mar;1(2):99-102. doi: 10.1002/lt.500010205.
Giant hepatocellular adenomas are associated with a high incidence of rupture with intra-abdominal hemorrhage and may also undergo malignant transformation. If resection is not technically feasible, liver transplantation should be a treatment option. The aim of this report is to describe the indications, feasibility, and outcome of liver transplantation for hepatocellular adenomas. A 66-year-old man with a 17-cm hepatocellular adenoma originating in the left lobe but involving nearly the entire liver and a 35-year-old woman with a 20-cm tumor involving the right lobe of the liver and compressing the left lobe underwent liver transplantation without complication. In both cases, a histological diagnosis was made by core needle biopsy preoperatively, and resection was technically not possible. Hepatocellular adenoma involving nearly all of the liver with no evidence of malignant change was confirmed in the explant liver from both cases. Giant hepatocellular adenomas may be unresectable and require liver transplantation for complete removal to prevent potential rupture with hemorrhage or malignant transformation.
巨大肝细胞腺瘤与腹腔内出血破裂的高发生率相关，并且也可能发生恶变。如果手术切除在技术上不可行，肝移植应作为一种治疗选择。本报告的目的是描述肝细胞腺瘤肝移植的适应证、可行性及疗效。一名66岁男性，患有一个起源于左叶但几乎累及整个肝脏的17厘米肝细胞腺瘤，以及一名35岁女性，患有一个累及肝右叶并压迫左叶的20厘米肿瘤，二人接受了肝移植，均无并发症。在这两个病例中，术前均通过粗针活检做出了组织学诊断，且手术切除在技术上不可行。两例患者的切除肝脏均证实为几乎累及整个肝脏且无恶变证据的肝细胞腺瘤。巨大肝细胞腺瘤可能无法切除，需要进行肝移植以完全切除，从而预防潜在的破裂出血或恶变。
