von Schönfeld J, Lange R, Bug R, Erhard J
Department of Gastroenterology, University Clinic Essen, Germany.
Z Gastroenterol. 1998 Nov;36(11):977-81.
Patients with primary sclerosing cholangitis (PSC) are at increased risk for cholangiocarcinoma. This tumor usually is a fatal complication, median survival after diagnosis is less than six months. In an asymptomatic 29-year-old patient with long-standing PSC and ulcerative colitis, routine abdominal ultrasound demonstrated an irregular mass, 11 x 13 mm, in the gallbladder. Cholecystectomy was performed, and histological examination demonstrated a moderately differentiated adenocarcinoma with infiltration of all layers of the gallbladder and invasion of local lymphatic vessels. Extensive diagnostic work-up failed to consistently demonstrate metastatic disease, and the patient was offered a liver transplantation. 24 months after the operation, the patient feels well and there is no indication of tumor recurrence. In carefully selected patients with gallbladder carcinoma complicating PSC, liver transplantation may be a therapeutic option.
原发性硬化性胆管炎（PSC）患者发生胆管癌的风险增加。这种肿瘤通常是一种致命的并发症，诊断后的中位生存期不到六个月。在一名患有长期PSC和溃疡性结肠炎的29岁无症状患者中，常规腹部超声显示胆囊内有一个11×13毫米的不规则肿块。进行了胆囊切除术，组织学检查显示为中度分化腺癌，侵犯胆囊全层并累及局部淋巴管。广泛的诊断检查未能始终显示有转移性疾病，该患者接受了肝移植。术后24个月，患者感觉良好，没有肿瘤复发的迹象。对于精心挑选的合并PSC的胆囊癌患者，肝移植可能是一种治疗选择。
