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A special recurrent pattern in small hepatocellular carcinoma after treatment:bile duct tumor thrombus formation

World Journal of Gastroenterology 2011年第43期17卷 4817-4824页

作者： Qing-Yu Liu Dong-Ming Lai Chao Liu Lei Zhang Wei-Dong Zhang Hai-Gang Li Ming Gao Department of Radiology Sun Yatsen Memorial Hospital Sun Yat-sen University Guangzhou 510120 Guangdong Province China

AIM:To investigate the clinicopathologic features of bile duct tumor thrombus(BDTT) occurrence after treatment of primary small hepatocellular carcinoma(sHCC) .METHODS:A total of 423 patients with primary sHCC admitted to our hospital underwent surgical resection or local *** follow-up,only six patients were hospitalized due to obstructive jaundice,which occurred 5-76 mo after initial *** clinicopathologic features of these six patients were ***:Six patients underwent hepatic resection(n=5) or radio-frequency ablation(n=1) due to primary *** cases had an R1 resection margin,and one case had an ablative margin less than 5.0 *** vascular infiltration,microsatellites or bile duct/canaliculus affection was noted in the initial resected *** the follow-up,imaging studies revealed a macroscopic BDTT extending to the common bile duct in all six *** patients had a concomitant intrahepatic recurrent *** re-resection of intrahepatic recurrent tumors and removal of BDTTs(n=4) ,BDTT removal through choledochotomy(n= 1) ,and conservative treatment(n=1) was *** portal vein invasion was noted in three of the four resected *** six patients died,with a mean survival of 11 mo after BDTT removal or conservative ***:BDTT occurrence is a rare,special recurrent pattern of primary *** with BDTTs extending to the common bile duct usually have an unfavorable prognosis even following aggressive *** resection or ablative margins against primary sHCC may be a risk factor for BDTT development.

关键词： small hepatocellular carcinoma recurrence bile ducts jaundice diagnosis

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