- 期刊
Right Intra-Atrial and Renal Vein Thrombosis Due to Hepatocellullar Carcinoma-Report of a Case with Unusual CT Appearance
肝細胞癌併右心房及腎靜脈栓塞－電腦斷層攝影之個案報告
摘要
著者等籍此個案來闡明電腦斷層攝影於肝細胞癌併右心房栓塞診斷時所扮演之重要角色。個案爲72歲中國女性，主訢一周來有運動性呼吸困難，下肢水腫．乙型肝炎表面抗原呈陽性反應，α胎兒蛋白偏高(290ng/ml)。胸腹部CT顯示有一個低密度，不均勻之右葉肝腫瘤，併有嚴重的經血管蔓延，侵入肝靜脈，肝門脈，經下腔靜脈上行進入右心房，更逆行進入了腎靜脈。患者病況惡化，黃膽，腹水，無尿等加劇，終於病亡。其實，任何惡性腫瘤除了中樞神經者外都有可能轉移到心髒，因此吾等認爲當右心室與肝髒同時都發現有腫瘤時，肝細胞癌應列入鑑別診斷。
並列摘要
The role of computed tomography (CT) in diagnosing right intra-atrial extension of hepatocellular carcinoma (HCC) is well-illustrated in this case of a 72-year-old Chinese female, who complained of exertional dyspnea, pitting edema of lower legs for 1 week. She had a positive Hepatitis B surface antigen and a high serum level of alpha fetoprotein (290ng/ml). Chest and abdominal CT showed a low density, heterogeneous right hepatic tumor with extensive propagation intravascularly into hepatic veins, portal vein, inferior vena cava with ante grade growth into the right atrium, and retrograde thrombus formation into the renal veins. Progression of jaundice, ascites, orthopnea and anuria were noted. It is well-known that any type of malignant tumor (except CNS) could have a possibility of cardiac involvement. Consequently, we suggest that HCC should be included in the differential diagnosis especially when right intra-atrial and liver tumor are detected simultaneously.
延伸閱讀
- Chen, S. C., Hsieh, M. Y., Lin, Z. Y., Wang, L. Y., Jan, C. M., Chen, C. Y., Liu, H. W., Chang陳立宗, W. Y., Chuang, W. L., & Chu (1986). 肝細胞癌及肝轉移癌門靜脈栓塞之超音波檢查. The Kaohsiung Journal of Medical Sciences, 2(6), 408-413. https://doi.org/10.6452/KJMS.198606.0408
- Huang, Y. T., & Yen, C. J. (2014). 肝細胞癌個案合併心臟侵犯. 台灣癌症醫學雜誌, 1(2), 158-162. https://doi.org/10.6323/JCRP.2014.1.2.10
- 孔慶惠、鄭慶明、王永成、吳昭瑩、李紋瑜、范君凱、黃永堅（2000）。小型肝血管瘤在雙相迴旋型電腦斷層攝影中的表現。中華放射線醫學雜誌，25(6)，241-245。https://www.airitilibrary.com/Article/Detail?DocID=10188940-200012-25-6-241-245-a
- Yu, C. (1984). 電腦斷層攝影對肝細胞癌侵襲門靜脈的評估. 中華放射線醫學雜誌, 9(2), 93-102. https://www.airitilibrary.com/Article/Detail?DocID=10188940-198406-9-2-93-102-a
- 郭萬祐、楊建芳、蘇友吉、田雨生、何永仁、姜仁惠、張遵（1985）。肝癌之肝動脈門脈間瘻管栓塞治療－病例報告。中華放射線醫學雜誌，10(2)，143-146。https://www.airitilibrary.com/Article/Detail?DocID=10188940-198506-10-2-143-146-a