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机构地区:[1]中国医科大学附属盛京医院肝胆脾外科,辽宁省沈阳市110004 [2]中国医科大学附属盛京医院病理科,辽宁省沈阳市110004
出 处:《世界华人消化杂志》2013年第14期1327-1332,共6页World Chinese Journal of Digestology
摘 要:目的:探讨肝脏未分化胚胎性肉瘤(undifferen-tiated embryonal sarcoma of the liver,UESL)的诊断与治疗.方法:回顾性总结分析本院2005-2011年住院手术治疗并经术后病理组织学检查确认的4例UESL患者的临床资料.结果:男1例,女3例,年龄分别为6岁、14岁、14岁和46岁.既往无肝病背景,其临床表现主要为腹部包块、腹痛和发热等.术前常规化验检查显示肝功能基本正常,肝炎病毒标志物和甲胎蛋白等肿瘤标志物均为阴性.术前影像学检查确诊较困难,术后病理组织学检查均确诊为UESL.所有患者均行根治性手术切除,其中2例因出现发热和腹膜炎体征而疑有肿瘤破裂出血,转行急诊手术治疗,并于术后联合行化学药物辅助治疗.结论:UESL是一种少见的高度恶性肿瘤,无特异性临床表现,术前难以确诊;治疗上仍以手术完整切除肿瘤为首选,联合化疗等综合辅助治疗可进一步提高疗效.AIM: To explore the diagnosis and treatment of undifferentiated embryonal sarcoma of the liver (UESL). METHODS: Clinical data for four patients with pathologically confirmed UESL who were treat- ed at our hospital between 2005 and 2011 were retrospectively analyzed. RESULTS: Three children (2 female and I male) and one female adult were included. Their age was 14, 14, 6 and 46 years old, respectively. Clini- cal presentation was typically an abdominal mass that may be accompanied by pain and/or fever. Diagnosis relies on histopathological examina-tion and it is difficult for radiological examination to establish a definite diagnosis. Tumors were removed surgically in all four patients, and two patients received adjuvant chemotherapy. CONCLUSION: UESL is an unusual malignancy of the liver. Whenever feasible, radical resection should be attempted as a part of combination modalities. Multiagent adjuvant chemotherapy and supportive therapy might improve sur- vival.
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