肝胆恶性肿瘤皮肤转移8例的临床观察

Analysis of 8 cases of hepatobiliary malignant tumor cutaneous metastatic

目的探讨肝胆恶性肿瘤出现皮肤转移患者临床特征。方法选取肝胆恶性肿瘤出现皮肤转移的患者8例,均为2013年5月至2015年5月收治,分析其临床特征及预后。结果 1例肝细胞癌在剖腹探查时,受出血原因的影响,仅取病理组织检查,10个月后,检出切口皮下有2.5cm×2.5cm的肿瘤,行切口肿瘤切除和肝脏左叶切除后,存活时间为9个月;1例肝门部胆管癌,采取根治切除手术治疗后2个月,发现上肢、头皮、双肺皮肤出现多发转移的情况,患者放弃治疗自行离院,存活时间为3个月;1例肝门部胆管癌,颈部检出皮肤单发肿瘤,随访示存活时间为10个月;1例胆管细胞癌和混合型肝细胞癌,皮肤多发转移,细针穿刺皮肤结果,病检结果为胆管细胞癌,实施化疗治疗,存活时间为3个月;1例肝细胞癌胆管癌栓与梗阻性黄疸合并发生,对皮肤穿刺点观察,有类圆形结节检出,切除皮肤肿瘤后,存活时间已有15个月,未出现复发情况;1例肝门部胆管癌,到院就诊时,右大腿检出皮肤单发肿瘤,随访示存活时间为9个月。结论为防范肝胆肿瘤发生皮肤种植转移,需对切口保护技术和穿刺技术改进,针对肝胆肿瘤发生单发皮肤转移的病例,可应用手术方案治疗,可取得理想成效,针对多发皮肤转移,需采取综合治疗手段,以保障患者生存质量。

Objective To investigate the clinical characteristics of patients with hepatobiliary malignancies appear cuta- neous metastatic. Methods Selected hepatobiliary cancer patient g skin metastases appeared eight cases, all in our hospital from May 2013 to May 2015 were treated to analyze the clinical features and prognosis. Results After one case of hepatocellular carcinoma at laparotomy affected causes of bleeding, take only pathological examination, 10 months after detection 2. 5cm - 2. 5cm incision subcutaneous tumors, tumor resection incision and left lobe of liver resection , survival time was 9 months ; One case of hilar cholangiocarcinoma, taken after radical resection surgery two months, found that upper limbs, scalp, skin cases of multiple lung metastases, patients gave up treatment on their own away from the hospital, survival time was three months ; One case of hilar cholangiocarcinoma, neck skin single tumor detection, follow - up shows survival time was 10 months ; One case of bile duct cell carcinoma and mixed hepatocellular carcinoma, skin multi- ple metastases, fine -needle aspiration skin as a result, pathological examination results for cholangiocarcinoma, implementation and chemotherapy treatment, survival time is three months; One case of bepatocellular cholangiocarcinoma tied with obstructive jaundice merger of the skin puncture site observation, there are round nodule detection after removal of skin cancer, the survival time for 15 months, recurrence does not appear; One case of hilar cholangiocarcinoma, when to the hospital, the right thigh skin single tumor detection, follow - up shows survival time was 9 months. Conclusion To prevent hepatobiliary tumors skin metastasis, the need to cut protection technology and puncture technical improvements, for cases of single skin metastasis of hepatobiliary tumors, can be applied to surgical regimen, can achieve the desired results, the transfer for multiple skin, need to take a comprehensive treatment means to protect patient quality of life.