BACKGROUND Sarcomatoid intrahepatic cholangiocarcinoma(SICC)is an extremely rare and highly invasive malignant tumor of the liver.The precise pathologic mechanism of SICC has not been clearly identified,and the progno...BACKGROUND Sarcomatoid intrahepatic cholangiocarcinoma(SICC)is an extremely rare and highly invasive malignant tumor of the liver.The precise pathologic mechanism of SICC has not been clearly identified,and the prognosis is very poor.The effectiveness of the treatment strategy of radical hepatectomy combined with Huaier granules has not yet been reported.CASE SUMMARY The patient was a 69-year-old male who presented with intermittent right upper abdominal pain for one month and 4-pound weight loss before admission.Abdominal magnetic resonance imaging and magnetic resonance cholangiopancreatography showed multiple stones in the bile ducts accompanied by dilatation of the intrahepatic and extrahepatic bile ducts.The preoperative diagnoses were right intrahepatic bile duct stones and extrahepatic bile duct stones;thus,surgical resection was performed.Choledochoscopy showed that the bile duct wall of the right anterior lobe was thickened,and a mass was visible in the duct.Then,a biopsy was performed,and rapid frozen-section biopsy analysis indicated that the tumor was malignant.The final diagnosis was SICC(T1a N0M0).Huaier granules were taken by the patient as anticancer therapy after surgery.The patient attended follow-up for 72 mo with no tumor recurrence or metastasis.CONCLUSION Sarcomatous intrahepatic cholangiocarcinoma is an extremely rare,aggressive malignancy,and the diagnostic gold standard is pathological diagnosis.We reported the first case of successful treatment with Huaier granules as anticancer therapy after surgery,which indicated that Huaier granules are safe and effective.Further studies are needed to study the anticancer molecular mechanisms of Huaier granules in sarcomatous intrahepatic cholangiocarcinoma.展开更多
The proportion of liver transplantation(LT)for hepatocellular carcinoma(HCC)has kept on increasing over the past years and account for 20%-40%of all LT.Post-transplant HCC recurrence is considered the most important f...The proportion of liver transplantation(LT)for hepatocellular carcinoma(HCC)has kept on increasing over the past years and account for 20%-40%of all LT.Post-transplant HCC recurrence is considered the most important factor affecting the long-term survival of patients.The use of different types of immunosuppressive agents after LT is closely associated with an increased risk for HCC recurrence.The most commonly used conventional immunosuppressive drugs include the calcineurin inhibitors tacrolimus(FK506)and mammalian target of rapamycin inhibitor rapamycin(RAPA).Compared with tacrolimus,RAPA may carry an advantage in survival benefit because of its anti-tumor effects.However,no sufficient evidence to date has proven that RAPA could increase long-term recurrence-free survival and its anti-tumor mechanism of combined therapy remains incompletely clear.In this review,we will focus on recent advances in clinical application experience and basic research results of RAPA in patients undergoing LT for HCC to further guide the clinical practice.展开更多
文摘BACKGROUND Sarcomatoid intrahepatic cholangiocarcinoma(SICC)is an extremely rare and highly invasive malignant tumor of the liver.The precise pathologic mechanism of SICC has not been clearly identified,and the prognosis is very poor.The effectiveness of the treatment strategy of radical hepatectomy combined with Huaier granules has not yet been reported.CASE SUMMARY The patient was a 69-year-old male who presented with intermittent right upper abdominal pain for one month and 4-pound weight loss before admission.Abdominal magnetic resonance imaging and magnetic resonance cholangiopancreatography showed multiple stones in the bile ducts accompanied by dilatation of the intrahepatic and extrahepatic bile ducts.The preoperative diagnoses were right intrahepatic bile duct stones and extrahepatic bile duct stones;thus,surgical resection was performed.Choledochoscopy showed that the bile duct wall of the right anterior lobe was thickened,and a mass was visible in the duct.Then,a biopsy was performed,and rapid frozen-section biopsy analysis indicated that the tumor was malignant.The final diagnosis was SICC(T1a N0M0).Huaier granules were taken by the patient as anticancer therapy after surgery.The patient attended follow-up for 72 mo with no tumor recurrence or metastasis.CONCLUSION Sarcomatous intrahepatic cholangiocarcinoma is an extremely rare,aggressive malignancy,and the diagnostic gold standard is pathological diagnosis.We reported the first case of successful treatment with Huaier granules as anticancer therapy after surgery,which indicated that Huaier granules are safe and effective.Further studies are needed to study the anticancer molecular mechanisms of Huaier granules in sarcomatous intrahepatic cholangiocarcinoma.
文摘The proportion of liver transplantation(LT)for hepatocellular carcinoma(HCC)has kept on increasing over the past years and account for 20%-40%of all LT.Post-transplant HCC recurrence is considered the most important factor affecting the long-term survival of patients.The use of different types of immunosuppressive agents after LT is closely associated with an increased risk for HCC recurrence.The most commonly used conventional immunosuppressive drugs include the calcineurin inhibitors tacrolimus(FK506)and mammalian target of rapamycin inhibitor rapamycin(RAPA).Compared with tacrolimus,RAPA may carry an advantage in survival benefit because of its anti-tumor effects.However,no sufficient evidence to date has proven that RAPA could increase long-term recurrence-free survival and its anti-tumor mechanism of combined therapy remains incompletely clear.In this review,we will focus on recent advances in clinical application experience and basic research results of RAPA in patients undergoing LT for HCC to further guide the clinical practice.
