Isolated metastasis to the gallbladder from hepatocellular carcinoma
Isolated metastasis to the gallbladder from hepatocellular carcinoma
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DOI：
10.1111/j.1872-034x.2010.00689.x
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发表时间：
2010-08-01
影响因子：
4.2
通讯作者：
Nagano, Hiroaki
中科院分区：
文献类型：
--
作者：
Murakami, Masahiro;Kobayashi, Shogo;Nagano, Hiroaki
目的：肝细胞癌（HCC）转移至胆囊（GB）是一种罕见的疾病，手术适应证的确定也很困难。方法：回顾性分析1998 ~ 2008年在我院行肝切除术的439例原发性肝癌患者中，393例（89.5%）同时行胆囊切除术。这些案件都没有直接入侵的证据。所有病例均为晚期门静脉血栓（PVTT），其主要肿瘤位于胆囊床附近。5例胆囊壁有明显的肿瘤肿块，3例胆囊静脉内仅有癌栓。6例术后局部应用干扰素治疗，3例长期生存。结论：8例原发性肝癌胆囊转移与PVTT密切相关。手术切除和多模式的治疗将是必要的长期生存孤立GB转移的情况下。
Aim:Metastasis to gallbladder (GB) from hepatocellular carcinoma (HCC) is rare, and it is difficult to determine indications for surgery. We report eight cases of synchronous isolated GB metastasis, and analyze their features retrospectively.Methods:Among 439 HCC patients who underwent hepatectomy from 1998 to 2008 at our institution, 393 (89.5%) underwent concurrent cholecystectomy.Results:Among them, eight (1.8%) had GB metastasis without other distant metastases. None of these cases showed evidence of direct invasion. All cases had advanced portal vein thrombus (PVTT) and their main tumor located near the GB bed. Five cases had apparent tumor mass in the GB wall, and the other three cases had only tumor thrombus in the GB veins. Six cases were treated postoperatively with local infusion therapy with interferon, and three of them showed long-term survival.Conclusion:Our eight cases of GB metastasis from HCC were closely related to PVTT. Surgical resection and multimodal treatment would be necessary for long-term survival in cases with isolated GB metastasis.