直肠癌伴同时性肝细胞癌一例并文献复习

Synchronous Hepatocellular Carcinoma with Multiple Intrahepatic Metastases and Adenocarcinoma of the Rectum: Report of One Case and Literature Review

目的探讨直肠癌同时合并肝细胞癌被误诊为直肠癌伴肝转移的原因。方法回顾我院1例直肠癌同时合并肝细胞癌患者的病例资料,对误诊原因进行分析。结果在直肠癌同时合并肝脏多发病灶的情况下,CT难以鉴别肝脏病变性质;临床医生忽略多原发癌的存在,是导致误诊的原因。结论在肝癌高发地区,结直肠癌患者同时出现肝脏病变,需考虑多原发癌的可能性,特别是乙肝病毒(HBV)感染及甲胎蛋白(AFP)升高的患者。

Objective To investigate the causes of misdiagnosed synchronous hepatocellular carcinoma with multiple intrahepatic metastases and adenocarcinoma of the rectum for rectal cancer with hepatic metastases. Methods A retrospective a- nalysis of the clinical data of a patient with synchronous hepatocellular carcinoma with multiple intrahepatic metastases and adeno- carcinoma of the rectum was carried out to find out the reasons for misdiagnosis. Results CT alone was not sufficient to identify the character of multiple liver lesions when rectal cancer was in existence, and the clinician neglected the possibility of multiple primary cancers. Conclusion In the area with high incidence of liver cancer, the possibility of multiple primary cancers should be considered for patients with colorectal cancer, especially those with combined HBV infection and elevated AFP.