肝癌肝移植术后肠系膜转移癌1例

A case report of mesenteric metastatic carcinoma after liver transplantation

患者男性,58岁,因"发现腹腔包块3 d"入院。患者10年前因原发性肝癌行肝移植术。PET-CT示左中下腹肠系膜上一分叶状软组织肿块,考虑为肠系膜上原发肿瘤或肝转移癌。肝未见占位性病变。术后病理检查报告为中分化腺癌侵及,考虑原有肝癌转移。肠系膜转移癌为肝细胞性肝癌较为少见,考虑原因为腔静脉癌细胞脱落及术后免疫逃逸。故术后应严密随访,以早期发现和治疗肿瘤转移,延长患者生存期。

A 58-year-old male patient was admitted to 371 Central Hospital of the PLA for ＂the abdominal mass 3 days ago＂. The patient had a liver transplant in our hospital because of the primary liver cancer 10 years ago. PET-CT scan showed a leaf shaped soft tissue mass on the left mesenteric mesentery, which was considered to be a primary mesenteric tumor or a hepatic metastatic carcinoma. There was no occupying lesion in the liver. Postoperative pathological diagnosis showed the middle differentiated adenocarcinoma, which might be caused by the metastasis of primary liver cancer. Mesenteric metastatic carcinoma was a kind of hepatocellular carcinoma, which was relatively rare. The reason might be that the vena cava was off and the postoperative immunization avoidance. So postoperative follow-up should be performed closely, which could lead to a longer life for the patients.