原发性肝细胞癌脾转移1例并文献复习

Primary hepatocellular carcinoma with spleen metastasis： a case report and literature review

目的探讨原发性肝细胞癌（hepatocellular carcinoma，HCC）脾转移的临床特征和诊疗方法。方法回顾性分析1例原发性HCC脾转移患者的临床资料，并综述相关文献，探讨其鉴别诊断和治疗进展。结果本例患者因腹胀就诊，CT提示肝、脾巨大占位性病变，在CT引导下经皮脾细针穿刺活检，病理诊断原发性HCC脾转移。患者临床分期cT4NxM1，1VB期，行最佳支持治疗2个月后自动出院。结论原发性HCC脾转移较罕见，CT引导下穿刺活检可明确病理诊断，治疗原则是姑息治疗。

Objective To investigate the clinical features, diagnosis and treatment of primary hepatocellular carci- noma （HCC） with splenic metastasis. Methods Retrospective analysis was performed using clinical data from 1 primary HCC patient with splenic metastasis. Meanwhile, related literatures was reviewed to investigate its differential diagnosis and treatment progress. Results This patient was admitted due to bellyache, and abdomen CT showed irregular mass in both the liver and spleen. Percutaneous fine - needle biopsy of the tumor in spleen was performed, and the diagnosis of primary HCC with spleen metastasis was confirmed. The patient was is in Stage cT4NxM1, Phase 1VB. Then, optimal supportive care was administered, and the patient was discharged two months later. Conclusions Primary HCC with splenic metastasis is rare, and palliative treatment can be adopted after pathological diagnosis.