Primary squamous cell carcinoma of the liver: an uncommon finding in contrast-enhanced ultrasonography imaging.
Primary squamous cell carcinoma of the liver: an uncommon finding in contrast-enhanced ultrasonography imaging.
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DOI：
10.1159/000334425
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发表时间：
2011-09
影响因子：
0.6
通讯作者：
Fujimoto J
中科院分区：
文献类型：
--
作者：
Iimuro Y;Asano Y;Suzumura K;Yada A;Hirano T;Iijima H;Nishiguchi S;Hirota S;Fujimoto J
原发性肝鳞状细胞癌(SCC)是一种预后不良的罕见肿瘤。我们报告一例晚期原发性肝鳞状细胞癌，发生在非寄生虫性肝囊肿附近，侵犯右横隔膜和右肺组织。超声造影(CE-US)显示血管晚期有独特的强化，与肝细胞癌、胆管细胞癌或转移性腺癌的表现不一致。患者接受了手术切除肿瘤，然后用5-氟尿嘧啶(5-FU)和顺铂(CDDP)进行全身化疗，而由于表现相对较差，没有进行放射化疗。虽然术后4个月后图像分析显示无复发，但患者在术后13个月死于复发。免疫组织化学分析显示，该鳞状细胞癌含有大量表达CD31或CD34的毛细血管内皮细胞，这可能反映了CE-US在血管晚期的独特成像模式，这已在胆管细胞癌中报道。此外，我们还回顾了文献中哪些治疗方法适用于晚期肝原发SCC。从综述中可以看出，如果可能的话，放射治疗、全身化疗(5-FU和CDDP)和手术切除相结合是治疗晚期原发性肝鳞状细胞癌的合适方法。
Primary squamous cell carcinoma (SCC) of the liver is rare tumor with an unfavorable prognosis. We report a case of advanced primary SCC of the liver arising adjacent to a nonparasitic liver cyst, invading into the right diaphragm and the right lung tissue. Contrast-enhanced ultrasonography (CE-US) demonstrated unique enhancement in the late vascular phase, which was incompatible with those observed in hepatocellular carcinoma, cholangiocellular carcinoma, or metastatic adenocarcinoma. The patient underwent surgical resection of the tumor followed by systemic chemotherapy with 5-fluorouracil (5-FU) and cisplatin (CDDP), while radiation chemotherapy was not applied because of relatively poor performance status. Although postoperative image analysis revealed no recurrence 4 months later, the patient died 13 months after the operation from recurrence. Immunohistological analysis of the resected specimen revealed that this SCC contained many capillary endothelial vessels expressing CD31 or CD34, possibly reflecting the unique imaging pattern in the late vascular phase of CE-US, which has been reported in choangiolocellular carcinoma. In addition, we reviewed which kind of treatment would be suitable for advanced hepatic primary SCC in the literature. From the review, it could be proposed that a combination of radiation therapy, systemic chemotherapy (5-FU and CDDP) and surgical resection, if possible, is appropriate for advanced primary SCC of the liver.