偶发性肝细胞癌 骨转移 在列为肝移植的患者中
Jake W Levine1, Fadi Hawa1, Patricia P Bloom1
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI.
ACG case reports journal
|March 6, 2024
概括
这一案例突出了偶尔发生的转移性肝癌,特别是肝细胞癌,在肝硬化患者的骨中发现. 早期检测和诊断对于管理这种晚期肝癌至关重要.
科学领域:
- 肝病学和瘤学 肝病学和瘤学
- 诊断成像和病理学诊断成像和病理学
背景情况:
- 一名67岁的男性有酒精病史和C型肝炎相关的肝硬化,呈现肝脏脑病变.
- 住院期间的偶然发现导致了对潜在恶性瘤的调查.
- 以前的肝脏成像显示不确定的病变 (LI-RADS-3),没有肝细胞癌的病史.
研究的目的:
- 报告一种罕见的发生性转移性肝细胞癌在骨中诊断的罕见病例.
- 强调肝硬化和不确定的肝损伤患者的彻底调查的重要性.
主要方法:
- 腹部和骨盆计算机断层扫描 (CT) 由于在体检查期间出现血而进行.
- 在阴茎支部的骨活检证实了转移性肝细胞癌.
- 阿尔法胎儿蛋白水平处于正常范围内;连续肝脏成像没有显示明确的恶性瘤.
主要成果:
- 在左后下阴茎支骨中发现了一种形骨损伤.
- 骨活检证实了转移性肝细胞癌,尽管正常的α胎儿蛋白和不确定的肝脏成像.
- 患者在恢复基线精神状态后没有报告骨头疼痛.
结论:
- 转移性肝细胞癌可以偶尔出现在骨中,即使有正常的瘤标志物和最初不确定的肝损伤.
- 这一案例强调了需要高可疑指数和全面的诊断工作在肝硬化患者有不明原因的发现.
- 骨活检对于疑似转移性癌症的未知原始来源的最终诊断至关重要.
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