BACKGROUND Hepatic solitary fibrous tumor(SFT)is a rare neoplasm.Up to now,only 90 cases have been reported in the English language literature.This report describes a case of SFT of the liver misdiagnosed as hepatocel...BACKGROUND Hepatic solitary fibrous tumor(SFT)is a rare neoplasm.Up to now,only 90 cases have been reported in the English language literature.This report describes a case of SFT of the liver misdiagnosed as hepatocellular carcinoma.CASE SUMMARY A 42-year-old male had a two-year history of a gradually enlarging intrahepatic nodule.The preoperative imaging revealed a mass with a size of 2.7 cm×2.3 cm located in the segment IV of the liver.The patient was subjected to the resection of the segment IV,such as the medial segment of the left lobe of the liver.The histological examination of the mass showed various spindled cells irregularly arranged in the stroma.The immunohistochemistry of this mass revealed a positive staining for CD34 and STAT6.The history of intracranial tumor and postoperative pathological results led to the diagnosis of SFT of the liver(SFTL)due to a metastasis from the brain.CONCLUSION SFTL is an uncommon mesenchymal neoplasm that can be easily overlooked or misdiagnosed.The best treatment choice is the complete surgical resection of the mass.A regular follow-up after the surgery should be performed due to the poor prognosis of metastatic or recurrent SFT.展开更多
BACKGROUND Laparoscopic cholecystectomy(LC)and laparoscopic common bile duct exploration(LCBDE)has been widely used for management of gallbladder and common bile duct(CBD)stones.Post-operative clip migration is a rare...BACKGROUND Laparoscopic cholecystectomy(LC)and laparoscopic common bile duct exploration(LCBDE)has been widely used for management of gallbladder and common bile duct(CBD)stones.Post-operative clip migration is a rare complication of laparoscopic biliary surgery,which can serve as a nidus for stone formation and cause recurrent cholangitis.CASE SUMMARY A 59-year-old female was admitted to hospital because of fever and acute right upper abdominal pain.She has a history of LC and had a LCBDE surgery 2 mo ago.Physical examination revealed tenderness in the upper quadrant of right abdomen.Computed tomography scan demonstrated a high-density shadow at the distal CBD,which was considered as migrated clips.The speculation was confirmed by endoscopic retrograde cholangiopancreatography examination,and two displaced Hem-o-lok clips were removed with a stone basket.No fever or abdominal pain presented after the operation.In addition to the case report,literature regarding surgical clip migration after laparoscopic biliary surgery was reviewed and discussed.CONCLUSION Incidence of postoperative clip migration may be reduced by using clips properly and correctly;however,new methods should be explored to occlude cystic duct and vessels.If a patient with a past history of LC or LCBDE presents with features of sepsis and recurrent upper quadrant pain,clip migration must be considered as one of the differential diagnosis.展开更多
基金Supported by National Natural Science Foundation of China,No.81770614.
文摘BACKGROUND Hepatic solitary fibrous tumor(SFT)is a rare neoplasm.Up to now,only 90 cases have been reported in the English language literature.This report describes a case of SFT of the liver misdiagnosed as hepatocellular carcinoma.CASE SUMMARY A 42-year-old male had a two-year history of a gradually enlarging intrahepatic nodule.The preoperative imaging revealed a mass with a size of 2.7 cm×2.3 cm located in the segment IV of the liver.The patient was subjected to the resection of the segment IV,such as the medial segment of the left lobe of the liver.The histological examination of the mass showed various spindled cells irregularly arranged in the stroma.The immunohistochemistry of this mass revealed a positive staining for CD34 and STAT6.The history of intracranial tumor and postoperative pathological results led to the diagnosis of SFT of the liver(SFTL)due to a metastasis from the brain.CONCLUSION SFTL is an uncommon mesenchymal neoplasm that can be easily overlooked or misdiagnosed.The best treatment choice is the complete surgical resection of the mass.A regular follow-up after the surgery should be performed due to the poor prognosis of metastatic or recurrent SFT.
基金Medical and Health Technology Plan of Zhejiang Province,No.2019RC179.
文摘BACKGROUND Laparoscopic cholecystectomy(LC)and laparoscopic common bile duct exploration(LCBDE)has been widely used for management of gallbladder and common bile duct(CBD)stones.Post-operative clip migration is a rare complication of laparoscopic biliary surgery,which can serve as a nidus for stone formation and cause recurrent cholangitis.CASE SUMMARY A 59-year-old female was admitted to hospital because of fever and acute right upper abdominal pain.She has a history of LC and had a LCBDE surgery 2 mo ago.Physical examination revealed tenderness in the upper quadrant of right abdomen.Computed tomography scan demonstrated a high-density shadow at the distal CBD,which was considered as migrated clips.The speculation was confirmed by endoscopic retrograde cholangiopancreatography examination,and two displaced Hem-o-lok clips were removed with a stone basket.No fever or abdominal pain presented after the operation.In addition to the case report,literature regarding surgical clip migration after laparoscopic biliary surgery was reviewed and discussed.CONCLUSION Incidence of postoperative clip migration may be reduced by using clips properly and correctly;however,new methods should be explored to occlude cystic duct and vessels.If a patient with a past history of LC or LCBDE presents with features of sepsis and recurrent upper quadrant pain,clip migration must be considered as one of the differential diagnosis.
