Background: With the advances of imaging techniques, the detection rate of rare liver tumor is increased. However, the therapeutic strategies of the rare liver tumors remain limited. Methods: We analyzed twelve pathol...Background: With the advances of imaging techniques, the detection rate of rare liver tumor is increased. However, the therapeutic strategies of the rare liver tumors remain limited. Methods: We analyzed twelve pathologically confirmed rare liver tumors in 8 patients. All of the patients underwent ultrasound(US) guided biopsy and subsequent thermal ablation. The tumors were ablated according to the preoperative plans and monitored by real-time US. CT/MRI fused with contrast enhanced US(CEUS) or three-dimensional(3 D) US-CEUS images were used to guide and assess the ablation zone more accurately during thermal ablation. The rate of technical efficacy was assessed based on the contrast-enhance CT/MRI(CECT/MRI) results one month after ablation. Local tumor progression(LTP), recurrence and complications were followed up and recorded. Results: Among these twelve nodules, nine were subject to US-guided thermal ablation, whereas the other three inconspicuous nodules were subject to CEUS-guided thermal ablation. Intra-procedure CT/MRI-CEUS or 3 D US-CEUS fusion imaging assessments demonstrated that the ablation zone sufficiently covered the original tumor, and no immediate supplementary ablation was required. Additionally, no major complications were observed during the follow-up period. The postoperative CECT/MRI confirmed that the technique success rate was 100%. Within the surveillance period of 13 months, no LTP or recurrence was noted. Conclusions: US-guided thermal ablation was feasible and safe for rare liver tumors. The use of fusion imaging technique might make US-guided thermal ablation as effective as surgical resection, and this technique might serve as a potential therapeutic modality for rare liver tumors in the future.展开更多
Nested stromal-epithelial tumor(NSET) is a nonhepatocytic and non-biliary tumor of the liver consisting of nests of epithelial and spindled cells with associated myofibroblastic stroma and variable intra-lesional calc...Nested stromal-epithelial tumor(NSET) is a nonhepatocytic and non-biliary tumor of the liver consisting of nests of epithelial and spindled cells with associated myofibroblastic stroma and variable intra-lesional calcification and ossification, which represents a very rare and challenging disease. Most of the reported cases have been treated with surgery, obtaining a long survival outcome. Here, we report the case of a 31-year-old Caucasian man who underwent surgery at our institution for a large, lobulated, multinodular mass of the right hemi-liver. The histological exam confirmed the diagnosis of NSET. After 6 mo from surgery, a liver recurrence was described and a chemoembolization was performed. After a further disease progression, based on the correlation between the histological features of the disease and those of the hepatoblastoma, a similar chemotherapy regimen(with cisplatin and ifosfamide/mesna chemotherapy, omitting doxorubicin due to liver impairment) was administered. However, infection of the biliary catheter required a dose modification of the treatment. No benefit was noted and a progression of disease was radiologically assessed after only four cycles. The worsening of the clinical status prevented further treatments, and the patient died a few months later. This case report documents how the NSET might have an aggressive and non-preventable behavior. No chemotherapy schedules with a proved efficacy are available, and new data are needed to shed light on this rare neoplasm.展开更多
目的探讨成人肝脏少见肿瘤或肿瘤样变的诊断和治疗。方法收集2009年6月至2015年5月收治的18例肝脏少见肿瘤或肿瘤样变患者的临床资料,回顾性分析临床诊治过程。结果 18例患者中,纤维瘤2例,腺瘤3例,局灶结节性增生4例,癌肉瘤2例,错构瘤2...目的探讨成人肝脏少见肿瘤或肿瘤样变的诊断和治疗。方法收集2009年6月至2015年5月收治的18例肝脏少见肿瘤或肿瘤样变患者的临床资料,回顾性分析临床诊治过程。结果 18例患者中,纤维瘤2例,腺瘤3例,局灶结节性增生4例,癌肉瘤2例,错构瘤2例,梭形细胞瘤1例,原发性肝恶性间质瘤1例,肝结核1例,炎性假瘤2例。8例影像学诊断出现误诊,良恶性诊断准确率为50%。1例炎性假瘤术前CA19-9为246.4 k U/L,其他病例肿瘤标志物均正常。除1例肝结核因术中见胃小弯多发肿大淋巴结和膈肌硬结未行肝脏肿块切除及1例腺瘤患者行射频消融外,其他病例均行肝脏病灶完整切除(包括局部切除、肝叶肝段切除)。结论肝脏少见肿瘤或肿瘤样变术前难以确诊,检查误诊率较高,主要依靠病理诊断,治疗以手术切除为主。展开更多
基金supported by grants from National Key R&D Program of China(2017YFC0112000)National Natural Science Foun-dation of China(81430038 and 81401434)+1 种基金Science and Technol-ogy Planning Project of Guangdong Province(2015A020214009,2016A020215072,and 2017A020215082)Natural Science Foundation of Guangdong Province(2016A030313205)
文摘Background: With the advances of imaging techniques, the detection rate of rare liver tumor is increased. However, the therapeutic strategies of the rare liver tumors remain limited. Methods: We analyzed twelve pathologically confirmed rare liver tumors in 8 patients. All of the patients underwent ultrasound(US) guided biopsy and subsequent thermal ablation. The tumors were ablated according to the preoperative plans and monitored by real-time US. CT/MRI fused with contrast enhanced US(CEUS) or three-dimensional(3 D) US-CEUS images were used to guide and assess the ablation zone more accurately during thermal ablation. The rate of technical efficacy was assessed based on the contrast-enhance CT/MRI(CECT/MRI) results one month after ablation. Local tumor progression(LTP), recurrence and complications were followed up and recorded. Results: Among these twelve nodules, nine were subject to US-guided thermal ablation, whereas the other three inconspicuous nodules were subject to CEUS-guided thermal ablation. Intra-procedure CT/MRI-CEUS or 3 D US-CEUS fusion imaging assessments demonstrated that the ablation zone sufficiently covered the original tumor, and no immediate supplementary ablation was required. Additionally, no major complications were observed during the follow-up period. The postoperative CECT/MRI confirmed that the technique success rate was 100%. Within the surveillance period of 13 months, no LTP or recurrence was noted. Conclusions: US-guided thermal ablation was feasible and safe for rare liver tumors. The use of fusion imaging technique might make US-guided thermal ablation as effective as surgical resection, and this technique might serve as a potential therapeutic modality for rare liver tumors in the future.
文摘Nested stromal-epithelial tumor(NSET) is a nonhepatocytic and non-biliary tumor of the liver consisting of nests of epithelial and spindled cells with associated myofibroblastic stroma and variable intra-lesional calcification and ossification, which represents a very rare and challenging disease. Most of the reported cases have been treated with surgery, obtaining a long survival outcome. Here, we report the case of a 31-year-old Caucasian man who underwent surgery at our institution for a large, lobulated, multinodular mass of the right hemi-liver. The histological exam confirmed the diagnosis of NSET. After 6 mo from surgery, a liver recurrence was described and a chemoembolization was performed. After a further disease progression, based on the correlation between the histological features of the disease and those of the hepatoblastoma, a similar chemotherapy regimen(with cisplatin and ifosfamide/mesna chemotherapy, omitting doxorubicin due to liver impairment) was administered. However, infection of the biliary catheter required a dose modification of the treatment. No benefit was noted and a progression of disease was radiologically assessed after only four cycles. The worsening of the clinical status prevented further treatments, and the patient died a few months later. This case report documents how the NSET might have an aggressive and non-preventable behavior. No chemotherapy schedules with a proved efficacy are available, and new data are needed to shed light on this rare neoplasm.
文摘目的探讨成人肝脏少见肿瘤或肿瘤样变的诊断和治疗。方法收集2009年6月至2015年5月收治的18例肝脏少见肿瘤或肿瘤样变患者的临床资料,回顾性分析临床诊治过程。结果 18例患者中,纤维瘤2例,腺瘤3例,局灶结节性增生4例,癌肉瘤2例,错构瘤2例,梭形细胞瘤1例,原发性肝恶性间质瘤1例,肝结核1例,炎性假瘤2例。8例影像学诊断出现误诊,良恶性诊断准确率为50%。1例炎性假瘤术前CA19-9为246.4 k U/L,其他病例肿瘤标志物均正常。除1例肝结核因术中见胃小弯多发肿大淋巴结和膈肌硬结未行肝脏肿块切除及1例腺瘤患者行射频消融外,其他病例均行肝脏病灶完整切除(包括局部切除、肝叶肝段切除)。结论肝脏少见肿瘤或肿瘤样变术前难以确诊,检查误诊率较高,主要依靠病理诊断,治疗以手术切除为主。