- 期刊
Chemotherapy-Sensitive Ectopic Hepatocellular Carcinoma with Multiple Mediastinal Metastasis-A Case Report
對化學治療敏感的異位性肝細胞癌合併多發性縱膈腔轉移：病例報告
摘要
異位性肝細胞癌是一個罕見疾病。定義為發生在肝臟外組織或器官的肝細胞癌。據我們所知目前只有36例病例報告發表在文獻上，但是沒有一例像我們的病人一樣在診斷時就已經合併多發性縱膈腔轉移。治療方式多是手術移除，並沒有文獻指出化學藥物治療的效果。我們報告一位病人因為上腹痛來到我們醫院，胸部X光攝影發現右肺門處有腫瘤。腹部電腦斷層發現靠近近端空腸有一8×6公分不規則顯影之腫瘤。此外病人的肝臟顯示為正常無腫瘤。而且他的胎兒蛋白指數高達25276 ng/ml。理學檢查發現雙側頸部有多發腫瘤，經病理切片證實為轉移性肝細胞癌。我們用cisplatin，doxorubicinc和cylophosphamide合併治療，結果令人滿意。治療後經一年追蹤，上述轉移性腫瘤在影像學上有明顯變小，病人胎兒蛋白指數也回復到正常，而且腹腔腫瘤的大小也有縮小。
並列摘要
Ectopic hepatocellular carcinoma (HCC) is an extremely rare disease. It is defined as an HCC arising from the hepatic parenchyma located in an extrahepatic organ or tissue. To the best of our knowledge, there have been only 36 cases reported in the literature, but there has not been a diagnosed case of multiple mediastinal metastases, such as ours. Treatment has been surgery, for the most part, and no effective chemotherapy regimens have been reported. We reported a 41-year-old man referred to our hospital because of upper abdominal pain. Chest X-ray disclosed a mass lesion at the right pulmonary hilum. Abdominal computed tomography (CT) disclosed a 8x6-cm heterogeneous enhanced mass near the proximal jejunum. The mother liver was intact without cirrhosis or tumor. His alpha fetoprotein was at an extremely high level (25276 ng/ml). Multiple neck lymphadenopathy was noted and biopsy proved metastatic HCC. We treated this patient with the combined chemotherapy regimen of cisplatin, doxorubicin and cylophosphamide. After 1 year of follow-up, the result was satisfactory, with a marked decrease in the size of the lymph nodes, and his alpha fetoprotein level returned to normal. In addition, the size of the lesion near the proximal jejunum had decreased.
延伸閱讀
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