西安交通大学学报（医学版）Issue(2)：285-286,140,3.DOI:10.7652/jdyxb201502027
原发性肝癌合并胆囊癌病例报道
A case report of primary hepatocellular carcinoma with gallbladder cancer
覃丹 1万永 1张晓刚 1梁华 2刘昌1
作者信息
- 1. 西安交通大学医学部第一附属医院 肝胆外科，陕西西安 710061
- 2. 西安交通大学医学部第一附属医院 病理科，陕西西安 710061
- 折叠
摘要
Abstract
ABSTRACT:Objective To a rare case of double primary cancer (hepatocellular carcinoma with gallbladder)to guide clinical application.Methods and Results We reported one case of primary hepatocellular carcinoma and gallbladder.A male patient,54 years old,had main complaints of intermittent right upper quadrant pain for 4 days. The abdominal CT of the local county hospital showed gallstones,gallbladder with liver infiltration.And then he went to the First Affiliated Hospital of Xi’an Jiaotong University for further treatment.Laboratory examination revealed:HBsAg(+),HBcAb(+),alpha-fetoprotein (AFP)> 60 500 ng/mL,carcinoembryonic antigen (CEA) 5.25 ng/mL.Abdominal CT showed hilar slightly stronger light echo groups:liver cancer or gallbladder cancer? Hepatic artery and portal vein CT imaging (CTA+CTV)examination showed the malignant tumor shadow in the inside of the left hepatic lobe huge,uneven thickening of the gallbladder wall,suspected liver disease with gallbladder infringement or gallbladder disease with liver infringement. With the preoperative preliminary consideration of primary liver cancer with infiltration of the gallbladder,we chose the operation as the resection of segment Ⅳ b and Ⅴ of the liver,cholecystectomy and T tube drainage.Pathological examination postoperative showed the bulky liver carcinoma grade Ⅲ and the poorly differentiated adenocarcinoma of gallbladder.A month later,abdominal CT showed the tumor spread intrahepatic,prompting the poor prognosis.Conclusion The two which are not continuous,which is the standard of double primary cancer,are not suitable for all double primary cancers.This case provides useful experience for future similar diagnosis and treatment of disease,and also helps us with timely and accurate identification of “metastatic”or “primary”,which is the key point for clinicians to give patients an effective treatment.关键词
双原发癌/原发性肝癌/胆囊癌Key words
multiple primary cancers/primary hepatocellular carcinoma/gall bladder cancer分类
医药卫生引用本文复制引用
覃丹,万永,张晓刚,梁华,刘昌..原发性肝癌合并胆囊癌病例报道[J].西安交通大学学报（医学版）,2015,(2):285-286,140,3.
