Primary Hepatic Adenosquamous Carcinoma with Peritoneal Carcinomatosis Presenting as Liver Abscess

原發性肝臟腺鱗癌是屬於膽道細胞癌的一種，腫瘤中同時有腺癌的分化也有鱗狀上皮癌的分化，相當少見，目前沒有辦法利用病人的症狀、抽血檢查及影像學檢查就可以直接診斷，必須要靠病理切片才能確診，治療以開刀合併化療為主，預後非常差，大多數的病人在確診後一年內都會死亡。我們這次是要報告一位原發性肝臟腺鱗癌的案例，一開始根據病人的初始症狀（腹部不適、發燒）及影像學檢查疑似病人有肝膿瘍，但後來經過更進一步的檢查後，確定病人有原發部位不明的轉移癌，在無法找到原發腫瘤的情況下，對肝臟的病灶做切片，最後確定是原發性肝臟腺鱗癌合併多處轉移，雖然確診後立刻接受化療的治療，但病人仍於確診後一個月死亡。我們回顧文獻探討此類複雜病況的策略。

關鍵字

原發性肝臟腺鱗癌；膽道細胞癌；腹膜癌；肝膿瘍

並列摘要

Primary hepatic adenosquamous carcinoma (ASC), a variant cholangiocellular carcinoma (CCC) subtype, is rare with very poor prognosis. It is difficult to diagnosis only with a serum marker and imaging study. We reported a case of primary hepatic ASC presenting with abdominal discomfort and fever. According to clinical features and imaging studies, liver abscess was diagnosed initially. After further evaluation, hepatic tumor with peritoneal carcinomatosis was suspected; biopsy of the hepatic tumor revealed carcinoma with both glandular and squamous differentiation, findings compatible with ASC. Because no other primary site was found for malignancy, primary hepatic ACS with peritoneal carcinomatosis was diagnosed. This patient succumbed from multiple organ failure 1 month after the diagnosis.

並列關鍵字

primary hepatic adenosquamous carcinoma ； cholangiocellular carcinoma ； peritoneal carcinomatosis ； liver abscess

國際替代計量

Primary Hepatic Adenosquamous Carcinoma with Peritoneal Carcinomatosis Presenting as Liver Abscess

全文下載

主題瀏覽