Peliosis hepatis(PH) is a rare benign condition characterized by the presence of multiple,randomly distributed,blood filled cystic areas of variable size within the liver parenchyma.PH is difficult to recognize and ma...Peliosis hepatis(PH) is a rare benign condition characterized by the presence of multiple,randomly distributed,blood filled cystic areas of variable size within the liver parenchyma.PH is difficult to recognize and may be mistaken for neoplasm,metastases or multiple abscesses.A 75-year-old female with a previous history of colon cancer was admitted when a liver mass in the right liver lobe was found 11 mo after surgery during the follow-up period.Computed tomography and magnetic resonance imaging scan of the abdomen were performed.The initial possible diagnosis was metastatic hepatocellular carcinoma.The patient underwent excision of the hepatic segment where the nodule was located.The pathological diagnosis of the surgical specimen was PH.PH should be considered in the differential diagnosis of new liver lesions in patients whose clinical settings do not clearly favor metastasization.Clinicians and radiologists must recognize these lesions to minimize the probability of misdiagnosis and inappropriate treatment.展开更多
AIM:To investigate the major complications after radiofrequency ablation(RFA) for the treatment of liver tumors and analyze possible risk factors that precipitate these complications.METHODS:From March 2001 to April 2...AIM:To investigate the major complications after radiofrequency ablation(RFA) for the treatment of liver tumors and analyze possible risk factors that precipitate these complications.METHODS:From March 2001 to April 2008,255 patients with liver tumors(205 male,50 female;age range,18-89 years;mean age,56.0 years) who received RFA were enrolled in this study.Of these patients,212 had hepatocellular carcinoma,39 had metastatic liver tumors and four had cholangiocellular carcinoma.One hundred and forty eight patients had a single tumor,and 107 had multiple tumors.Maximum diameter of the tumors ranged 1.3-20 cm(mean,5.1 cm).All patients were treated with a cooled-tip perfusion electrode attached to a radiofrequency generator(Radionics,Burlington,MA,USA).RFA was performed via the percutaneous approach(n = 257),laparoscopy(n = 7),or open surgical treatment(n = 86).The major complications related to RFA were recorded.The resultant data were analyzed to determine risk factors associated these complications.RESULTS:Among the 255 patients,425 liver tumors were treated and 350 RFA sessions were performed.Thirty-seven(10%) major complications were observed which included 13 cases of liver failure,10 cases of hydrothorax requiring drainage,three casesof tumor seeding,one case of upper gastrointestinal bleeding,one case ofintrahepatic abscess,one case of bile duct injury,one case of cardiac arrest,and five cases of hyperglycemia.Seven patients had more than two complications.Liver failure was the most severe complication and was associated with the highest mortality.Eleven patients died due to worsening liver decompensation.Child-Pugh classification(P = 0.001) and choice of approach(P = 0.045) were related to post-treatment liver failure,whereas patient age,tumor size and number were not significant factors precipitating this complication.CONCLUSION:RFA can be accepted as a relatively safe procedure for the treatment of liver tumors.However,attention should be paid to possible complications even though the incidences of these complications are rare.Careful patient selection and the best approach choice(percutaneous,laparoscopy,or laparotomy) will help to minimize the incidence and morbidity rate of complications which occur after RFA.展开更多
It is widely accepted that the indications for hepatectomy in colorectal cancer liver metastases and liver metastases of neuro-endocrine tumors result in relatively better prognoses, whereas, the indications and progn...It is widely accepted that the indications for hepatectomy in colorectal cancer liver metastases and liver metastases of neuro-endocrine tumors result in relatively better prognoses, whereas, the indications and prognoses of hepatectomy for non-colorectal non-neuroendocrine liver metastases(NCNNLM) remain controversial owing to the limited number of cases and the heterogeneity of the primary diseases. There have been many publications on NCNNLM; however, its background heterogeneity makes it difficult to reach a specific conclusion. This heterogeneous disease group should be discussed in the order from its general to specific aspect. The present review paper describes the general prognosis and risk factors associated with NCNNLM while specifically focusing on the liver metastases of each primary disease. A multidisciplinary approach that takes into consideration appropriate timing for hepatectomy combined with chemotherapy may prolong survival and/or contribute to the improvement of the quality of life while giving respite from systemic chemotherapy.展开更多
文摘Peliosis hepatis(PH) is a rare benign condition characterized by the presence of multiple,randomly distributed,blood filled cystic areas of variable size within the liver parenchyma.PH is difficult to recognize and may be mistaken for neoplasm,metastases or multiple abscesses.A 75-year-old female with a previous history of colon cancer was admitted when a liver mass in the right liver lobe was found 11 mo after surgery during the follow-up period.Computed tomography and magnetic resonance imaging scan of the abdomen were performed.The initial possible diagnosis was metastatic hepatocellular carcinoma.The patient underwent excision of the hepatic segment where the nodule was located.The pathological diagnosis of the surgical specimen was PH.PH should be considered in the differential diagnosis of new liver lesions in patients whose clinical settings do not clearly favor metastasization.Clinicians and radiologists must recognize these lesions to minimize the probability of misdiagnosis and inappropriate treatment.
文摘AIM:To investigate the major complications after radiofrequency ablation(RFA) for the treatment of liver tumors and analyze possible risk factors that precipitate these complications.METHODS:From March 2001 to April 2008,255 patients with liver tumors(205 male,50 female;age range,18-89 years;mean age,56.0 years) who received RFA were enrolled in this study.Of these patients,212 had hepatocellular carcinoma,39 had metastatic liver tumors and four had cholangiocellular carcinoma.One hundred and forty eight patients had a single tumor,and 107 had multiple tumors.Maximum diameter of the tumors ranged 1.3-20 cm(mean,5.1 cm).All patients were treated with a cooled-tip perfusion electrode attached to a radiofrequency generator(Radionics,Burlington,MA,USA).RFA was performed via the percutaneous approach(n = 257),laparoscopy(n = 7),or open surgical treatment(n = 86).The major complications related to RFA were recorded.The resultant data were analyzed to determine risk factors associated these complications.RESULTS:Among the 255 patients,425 liver tumors were treated and 350 RFA sessions were performed.Thirty-seven(10%) major complications were observed which included 13 cases of liver failure,10 cases of hydrothorax requiring drainage,three casesof tumor seeding,one case of upper gastrointestinal bleeding,one case ofintrahepatic abscess,one case of bile duct injury,one case of cardiac arrest,and five cases of hyperglycemia.Seven patients had more than two complications.Liver failure was the most severe complication and was associated with the highest mortality.Eleven patients died due to worsening liver decompensation.Child-Pugh classification(P = 0.001) and choice of approach(P = 0.045) were related to post-treatment liver failure,whereas patient age,tumor size and number were not significant factors precipitating this complication.CONCLUSION:RFA can be accepted as a relatively safe procedure for the treatment of liver tumors.However,attention should be paid to possible complications even though the incidences of these complications are rare.Careful patient selection and the best approach choice(percutaneous,laparoscopy,or laparotomy) will help to minimize the incidence and morbidity rate of complications which occur after RFA.
文摘It is widely accepted that the indications for hepatectomy in colorectal cancer liver metastases and liver metastases of neuro-endocrine tumors result in relatively better prognoses, whereas, the indications and prognoses of hepatectomy for non-colorectal non-neuroendocrine liver metastases(NCNNLM) remain controversial owing to the limited number of cases and the heterogeneity of the primary diseases. There have been many publications on NCNNLM; however, its background heterogeneity makes it difficult to reach a specific conclusion. This heterogeneous disease group should be discussed in the order from its general to specific aspect. The present review paper describes the general prognosis and risk factors associated with NCNNLM while specifically focusing on the liver metastases of each primary disease. A multidisciplinary approach that takes into consideration appropriate timing for hepatectomy combined with chemotherapy may prolong survival and/or contribute to the improvement of the quality of life while giving respite from systemic chemotherapy.
