Spontaneous hemoperitoneum(SP) is defined as the presence of blood within the peritoneal cavity that is unrelated to trauma.Although there is a vast array of etiologies for SP,primary hepatocellular carcinoma and hepa...Spontaneous hemoperitoneum(SP) is defined as the presence of blood within the peritoneal cavity that is unrelated to trauma.Although there is a vast array of etiologies for SP,primary hepatocellular carcinoma and hepatic adenoma are considered to be the most common causes.Hepatic metastatic tumor associated with spontaneous rupture is rare.SP from hepatic metastatic trophoblastic tumor may initially present with a sudden onset of abdominal pain.Abdominal computed tomography(CT) plays an important role in establishing the diagnosis of SP,indicating its origin and etiology,and determining subsequent management.Herein,we report an uncommon case of hemoperitoneum from spontaneous rupture of a hepatic metastatic trophoblastic tumor in a young female patient.Interestingly,the contrast-enhanced CT findings demonstrated hypervascular hepatic masses with persistent enhancement at all phases,which were completely different from the common appearances of hepatic metastases.For SP resulting from hepatic metastatic tumors,surgical intervention is still the predominant therapeutic method,but the prognosis is very poor.展开更多
Background and Aims:To compare the efficacy and safety of physical thermal ablation(PTA),including radiofrequency ablation(RFA)and microwave ablation(MWA),combined with sorafenib and physical thermal ablation alone fo...Background and Aims:To compare the efficacy and safety of physical thermal ablation(PTA),including radiofrequency ablation(RFA)and microwave ablation(MWA),combined with sorafenib and physical thermal ablation alone for the control and treatment of hepatocellular carcinoma(HCC)according to the available literature.Methods:Comprehensive searches were performed on PubMed,Embase,CNKI,the Cochrane Library,China Biomedical Literature Database(known as CBM),Weipu Journal,and Wanfang Database.Meta-analysis was performed using Revman 5.3 software.Results:A total of 15 studies,consisting of 2,227 HCC patients,were selected and included in this meta-analysis.Compared with the RFA-alone group,the patients in the RFA+sorafenib group had longer 1-,2-,and 3-year overall survival(all p<0.05),better overall efficacy(p<0.0001),longer radiofrequency interval(p<0.001),and lower 2-year recurrence rate(p=0.02).The 1-year overall survival(p=0.003)and overall efficacy(p=0.002)of the MWA+sorafenib group were also higher than those of the MWA-alone group.The incidences of adverse reactions in the RFA+sorafenib group,such as hand-foot skin reactions(p<0.001),diarrhea and constipation(p=0.0001),hypertension(p=0.009),and alopecia(p<0.001),were significantly higher than those in the RFA-alone group.Conclusions:RFA or MWA combined with sorafenib has produced a better therapeutic effect on HCC than physical thermal ablation alone;however,adverse reactions have been obvious.It is necessary to evaluate the safety of combination therapy,and pay close attention to the adverse reactions that develop in patients.展开更多
文摘Spontaneous hemoperitoneum(SP) is defined as the presence of blood within the peritoneal cavity that is unrelated to trauma.Although there is a vast array of etiologies for SP,primary hepatocellular carcinoma and hepatic adenoma are considered to be the most common causes.Hepatic metastatic tumor associated with spontaneous rupture is rare.SP from hepatic metastatic trophoblastic tumor may initially present with a sudden onset of abdominal pain.Abdominal computed tomography(CT) plays an important role in establishing the diagnosis of SP,indicating its origin and etiology,and determining subsequent management.Herein,we report an uncommon case of hemoperitoneum from spontaneous rupture of a hepatic metastatic trophoblastic tumor in a young female patient.Interestingly,the contrast-enhanced CT findings demonstrated hypervascular hepatic masses with persistent enhancement at all phases,which were completely different from the common appearances of hepatic metastases.For SP resulting from hepatic metastatic tumors,surgical intervention is still the predominant therapeutic method,but the prognosis is very poor.
基金This work was supported by the National Natural Science Foundation of China(81802805)the Natural Science Foundation of Jilin Province(20200201490JC)the translation-clinical joint foundation of the First Hospital of Jilin University(No.2020-ZL-04).
文摘Background and Aims:To compare the efficacy and safety of physical thermal ablation(PTA),including radiofrequency ablation(RFA)and microwave ablation(MWA),combined with sorafenib and physical thermal ablation alone for the control and treatment of hepatocellular carcinoma(HCC)according to the available literature.Methods:Comprehensive searches were performed on PubMed,Embase,CNKI,the Cochrane Library,China Biomedical Literature Database(known as CBM),Weipu Journal,and Wanfang Database.Meta-analysis was performed using Revman 5.3 software.Results:A total of 15 studies,consisting of 2,227 HCC patients,were selected and included in this meta-analysis.Compared with the RFA-alone group,the patients in the RFA+sorafenib group had longer 1-,2-,and 3-year overall survival(all p<0.05),better overall efficacy(p<0.0001),longer radiofrequency interval(p<0.001),and lower 2-year recurrence rate(p=0.02).The 1-year overall survival(p=0.003)and overall efficacy(p=0.002)of the MWA+sorafenib group were also higher than those of the MWA-alone group.The incidences of adverse reactions in the RFA+sorafenib group,such as hand-foot skin reactions(p<0.001),diarrhea and constipation(p=0.0001),hypertension(p=0.009),and alopecia(p<0.001),were significantly higher than those in the RFA-alone group.Conclusions:RFA or MWA combined with sorafenib has produced a better therapeutic effect on HCC than physical thermal ablation alone;however,adverse reactions have been obvious.It is necessary to evaluate the safety of combination therapy,and pay close attention to the adverse reactions that develop in patients.
