肝脏原发性癌肉瘤3例并文献复习

Clinical analysis of 3 cases of primary liver carcinosarcoma

目的：探讨肝脏原发性癌肉瘤的临床特点、诊断、治疗策略和预后。方法：报告3例肝脏原发性癌肉瘤的详细临床资料并复习相关文献。结果：3例患者均为男性,年龄13-52岁,临床症状无特异性。腹部CT、超声和核磁共振检查均提示肝脏占位性病变。经手术及肝脏穿刺活检病理诊断,病变均符合肝癌肉瘤。结论：原发性肝脏癌肉瘤临床极少见,病变恶性程度高,手术效果差,对化疗不敏感,易转移复发,预后差。其诊断的确立需结合病史,肿瘤标志物、影像学检查和组织病理,尤其是免疫组化染色有助于明确诊断。临床需与其他肝脏占位性病变进行鉴别。

Objective：To analyzes the clinical features,diagnosis,treatment and prognosis of primary liver carcinosarcoma. Method： Retrospective analysis the clinical information of 3 cases of primary liver carcinosarcoma and review some related papers. Result：3 patients were males and aged from 13--52 without specific clinical symptoms. Abdominal CT, ultrasonography and nuclear Magnetic Resonance Imaging showed occupying lesion in the live. The pathological diagnosis was primary liver carcinosarcoma after surgical operation. Conclusion： Primary liver cancer sarcoma is a rare malignant tumor with high grade malignancy, poor result of surgical operation, insensitivity to chemotherapy, easy to metastasis and recurrence and poor prognosis. The diagnosis should depend on the results of case history, tumor markers, imaging and histopathology, especially the results of immunohistochemical staining. So other occupying lesions in the liver should be distinguished in clinic.