肝囊肿术后发现肝囊腺癌1例报告并文献复习  

Liver cystadenocarcinoma following postoperative huge hepatic cyst: a case report and review of literature

作　　者：李田园[1] 杨中印[2] 费健[2] 彭承宏[2] 

机构地区：[1]上海交通大学医学院附属瑞金医院瑞金临床医学院,上海200025 [2]上海交通大学医学院附属瑞金医院普外科,上海200025

出　　处：《诊断学理论与实践》2015年第4期313-317,共5页Journal of Diagnostics Concepts & Practice

摘　　要：目的:分析1例初诊为肝囊肿,后续治疗中发现巨大肝囊腺癌患者的临床资料,探讨肝囊肿与肝囊腺癌间的关系及肝囊腺癌的诊治。方法:分析上海瑞金医院1例初诊为肝囊肿的肝囊腺癌病例及1986年至2013年间文献报道的共42例肝囊腺癌患者的临床资料,探讨肝囊腺癌的诊治和鉴别。结果:初诊为"肝囊肿",最后确诊为"肝囊腺癌"的患者中,最常见的症状为腹痛或腹部不适、腹部肿块和腹胀。较常出现水平增高的肿瘤指标为糖类抗原19-9(CA19-9)、CA125和癌胚抗原(CEA)。影像学检查显示为多囊分隔、囊壁乳头状结节伴钙化等特征时则高度提示为囊腺癌。结论:易与单纯性肝囊肿混淆的肝囊腺癌可借助临床表现、实验室检查、特征性的影像学表现进行早期诊断。对于确诊为肝囊腺癌的患者,在肿瘤无远处转移的情况下,以手术切除为首选的治疗方法。Objective： To investigate the relationship between hepatic cyst and cystadenocarcinoma as well as the treatment of cystadenocarcinoma by analyzing the data from a case of cystadenocarcinoma initially diagnosed as hepatic cyst five years ago. Methods： Data from a patient with liver cystadenocarcinoma who was diagnosed as huge hepatic cyst five years ago were analyzed. A total of 42 cystadenocarcinom cases reported in literatureduring 1986 to 2013 were reviewed. Results： The 42 cases reported in literature were firstly diagnosed as simple hepatic cysts but turned to be cystadenocarcinoma in the following years. The average age was 58.6 years. Abdominal pain or discomfort, mass in abdomen and abdominal distension were the top three symptoms.The tumor markers commonly elevated were CA19-9、CA125 and CEA. It should be highly suspicious of cystadenocarcinoma when imaging data indicated the following one or more items：multilocular with septation,papillary nodular wall withcalcification. Conclusions： Characteristic laboratory data and imaging findings could be used for early diagnosis and differentiating cystadenocarcinoma from hepatic cysts. Tumor resection is the preferred treatment for cystadenocarcinom without distant metastasis.

关 键 词：肝囊腺癌 肝囊肿 诊断 

分 类 号：R735.7[医药卫生—肿瘤]