Perforated Malignant Fibrous Histiocytoma of the Colon Presented as Liver Abscess: Report of a Case

以肝膿瘍爲臨床表現的穿孔性大腸惡性纖維組織細胞瘤：一病例報告

陳建宏(Chien-Hung Chen) ； 張簡吉幸(Chi-Sin Chang-Chien) ； 盧聖芸(San-Yun Lu) ； 陳良(Leung Chen) ； 蔡成枝(Seng-Kee Chuah) ； 郭仲煌(Chung-Huang Kuo)

《臺灣消化醫學雜誌》 19卷3期 (2002/09) Pp. 215-222

https://doi.org/10.6557/GJT.200209_19(3).0007

摘要

一位61歲的家庭主婦罹患右上腹痛一個月，腹部超音波及電腦斷層顯示右肝有一個包含氣體的低超音波密度的腫塊。經抽吸後證實是肝膿瘍。而鋇劑灌腸檢查顯示鋇劑由結腸肝曲外滲到肝內。開刀檢視顯示一個硬結的腫瘤由結腸肝曲延伸進入肝。腫瘤有穿孔，此穿孔連接結腸腔至肝膿瘍。組織病理報告顯示大腸惡性纖維組織細胞瘤直接侵犯至肝。因為腹腔膿瘍不易控制又併發肺部膿瘍，病人三個月後因敗血性休克死亡。

關鍵字

惡性纖維組織細胞瘤 ； 腸穿孔 ； 肝膿瘍

並列摘要

A 61-year-old housewife was suffering from a right upper-quadrant abdominal pain for one month. An abdominal computed tomography scan revealed a gas-containing irregular hypodense mass in the right lobe of liver and ultrasound examination showed a large hypoechoic gas-containing mass in the same area. A liver abscess was confirmed by needle aspiration with pus. Barium enema study revealed extravasation of barium into the liver parenchyma from the hepatic flexure of the colon. Surgical intervention revealed an indurative tumor extending from the hepatic flexure of the colon into the liver and a perforation hole connecting the colon lumen to the abscess cavity. The histopathology confirmed the diagnosis of malignant fibrous histiocytoma of the colon with direct invasion to the liver. The patient died of septic shock three months later due to anastomotic leakage.

並列關鍵字

malignant fibrous histiocytoma ； intestinal perforation ； liver abscess