肝脏未分化性胚胎性肉瘤误诊分析  

MISDIAGNOSIS OF UNDIFFERENTIATED EMBRYONAL SARCOMA OF LIVER

作　　者：杨晓宇[1] 俞文隆[1] 史嵩[1] 沈宁佳[1] 范飞[1] 陈科济[1] 张永杰[1] 

机构地区：[1]第二军医大学东方肝胆外科医院胆道二科,上海200438

出　　处：《肝胆外科杂志》2011年第3期179-181,共3页Journal of Hepatobiliary Surgery

摘　　要：目的加强对原发性肝脏未分化性胚胎性肉瘤的认识,提高其诊断率及生存率。方法回顾分析我院2000年1月至2010年6月共13例肝脏未分化性胚胎性肉瘤临床资料,从临床及影像学角度,分析其误诊原因及随访结果。结果 13例患者中,男9例,女4例,最小年龄为8岁,最大年龄为63岁,中位年龄38岁。误诊为原发性肝癌6例,囊腺癌1例,肝母细胞瘤1例;诊断为肝占位5例。误诊原因主要有病灶临床及影像学表现不典型、医生认识不足、主观臆断等。13例误诊患者术后均无出血、黄疸、感染、肝性脑病等并发症发生;生存期最短为术后4个月,最长为术后20个月,中位生存期为7个月。结论肝脏未分化性胚胎性肉瘤的诊断相当困难,一但怀疑UES,尽快行手术切除,术后尽早行放疗、化疗等辅助治疗可提高患者生存率。Objective To deeply understand the undifferentiated embryonal sarcoma of liver（UES） and elevate its rate of correct diagnosis and survival rate.Methods In this study 13 patients under going hepatic resection were retrospectively studied from Jan 2000 to Jun 2010 in our hospital and we analyse the misdiagnosis and follow-up results of UES from the perspective of clinical and imaging.Results There are 9 males and 4 females in the group.Age at diagnosis of UES ranged from 8 to 63 years and the median age was 38 years.6 cases were misdiagnosed as hepatocellular carcinoma,1 cases as cystadenocarcinoma and 1 case as hepatoblastoma.5 cases were diagnosed as liver lesions.The main causes of misdiagnosis included atypical clinical and imaging features of UES,inexperienced recognition for UES,subjective assumptions and so on.There were no postoperative complications such as bleeding,jaundice,infection,hepatic encephalopathy and so on and the postoperative survival time ranged from 4 and 20 months and the median survival time was 7months.Conclusions Hepatic undifferentiated embryonal sarcoma is very difficult to diagnose correctly.Once UES is suspected,the operation should be performed as soon as possible and after operation,radiation therapy,chemotherapy and other adjuvant therapy should also received as early as possible which may improve the survival rate.

关 键 词：肝肿瘤 未分化胚胎性肉瘤 误诊 治疗 

分 类 号：R735.7[医药卫生—肿瘤]