以骨转移为首发症状的隐匿性肝癌1例报告并文献复习  

Occult liver cancer with bone metastasis as the initial symptom:a case report and literature review

作　　者：于敏[1] 于建新 丛振杰[1] 董成功[3] Yu Min;Yu Jianxin;Cong Zhenjie;Dong Chenggong(Department of Radiology,Yantaishan Hospital,Yantai 264025,China;Department of Stomatology,Yantaishan Hospital,Yantai 264025,China;Department of Pathology,Yantaishan Hospital,Yantai 264025,China)

机构地区：[1]山东省烟台市烟台山医院南院放射科,烟台264025 [2]山东省烟台市烟台山医院南院口腔科,烟台264025 [3]山东省烟台市烟台山医院南院病理科,烟台264025

出　　处：《中华转移性肿瘤杂志》2024年第3期260-263,共4页Chinese Journal of Metastatic Cancer

摘　　要：肝细胞癌发生肝外转移很常见,甚至不少病例以肝外转移为首发症状而就诊,但肝内原发癌灶往往同时存在,且影像学表现典型,容易被检出和诊断。而肝癌肝外转移却没有明确原发癌灶的病例罕见。本文报道1例以胸椎骨转移为首发症状的肝细胞癌病例,临床罕见。影像学检查在患者胸椎转移灶术后5个月发现肝内新发小肝癌,并详细记录了原发肝癌病灶从无到有及逐渐增大的进展过程。患者病情进展迅速,综合治疗11个月发生双肺转移,25个月后因双肺转移导致呼吸衰竭死亡。笔者汇报本例患者的诊治过程,以期为临床提供参考。Extrahepatic metastasis is very common in hepatocellular carcinoma,and even many cases are treated with extrahepatic metastasis as initial symptom.But the primary hepatic cancer often exists at the same time,and the imaging manifestations are typical,which is easy to be detected and diagnosed.However,extrahepatic metastases of liver cancer without clear primary cancer foci are rare.This study reported a case of hepatocellular carcinoma with thoracic vertebrae metastasis as initial symptom,which is clinically very rare.Imaging examination revealed a new small liver cancer focus was found 5 months after the surgery for thoracic vertebral metastasis.The detailed progression of primary liver cancer focus from non-existent to gradually increasing was recorded.The patient's disease progressed rapidly.After 11 months of combined treatment,the patient developed bilateral lung metastasis and died of respiratory failure after 25 months because of lung metastasis.This study reported the process of diagnosis and treatment in order to provide clinical reference.

关 键 词：骨转移 肝癌 迟发 

分 类 号：R735.7[医药卫生—肿瘤]