Mizukami Y, Nagashima T, Ikuta K, Chikamatsu E, Kurachi K, Kanemoto H, Yagi T, Ohhira S, Nimura Y
Department of Surgery, Enshu General Hospital, Hamamatsu, Japan.
Hepatogastroenterology. 1998 Sep-Oct;45(23):1462-7.
Gallbladder carcinoid is a rare disease. In previous reports, classical carcinoid, an entity with a good prognosis, has not been distinguished from endocrine cell carcinoma, a tumor associated with marked cell atypia and mitosis, and a poor prognosis. The patient was a 66 year old woman who presented to our hospital with a chief complaint of jaundice. Pre-operatively, she was diagnosed as having advanced gallbladder carcinoma invading the liver and the hepatic hilus. The patient underwent right hepatic trisegmentectomy with en bloc resection of the caudate lobe and extrahepatic bile ducts, extended lymph node clearance and left hepaticojejunostomy. Histopathological examination showed positive Grimelius staining, marked mitosis, and intense atypism, hence, the tumor was diagnosed as an endocrine cell carcinoma. Twelve years after surgery, the patient is healthy, without any sign of recurrence. We present this novel case of long-term survival and review the literature.
胆囊类癌是一种罕见疾病。在以往的报告中,预后良好的经典类癌尚未与内分泌细胞癌区分开来,内分泌细胞癌是一种伴有明显细胞异型性和有丝分裂且预后较差的肿瘤。该患者为一名66岁女性,因黄疸为主诉前来我院就诊。术前,她被诊断为晚期胆囊癌侵犯肝脏和肝门。患者接受了右肝三叶切除术,同时整块切除尾状叶和肝外胆管,扩大淋巴结清扫及左肝空肠吻合术。组织病理学检查显示嗜银染色阳性、有明显的有丝分裂和强烈的异型性,因此,该肿瘤被诊断为内分泌细胞癌。手术后12年,患者身体健康,无任何复发迹象。我们展示了这一长期存活的新病例并回顾了相关文献。