Concomitant Cholangiocarcinoma and Hepatocellular Carcinoma in a Hepatitis B Virus Carrier

合併膽管癌與肝細胞癌在B型肝炎帶原者

10.6558/MTJM.2001.6(4).10

袁天民(Tein-Ming Yuan)；楊美都(Mei-Due Yang)；林智一(Taz-Yi Lin)；賴光啟(Kuang-Chi Lai)；蘇進成(Jenn-Cheng Su)

肝細胞癌 ； 合併膽管癌與肝細胞癌 ； 膽管癌 ； cholangiocellular carcinoma ； combined hepatocellular carcinoma and cholangiocellular carcinoma ； hepatocellular carcinoma

Mid-Taiwan Journal of Medicine

6卷4期（2001 / 12 / 01）

253 - 258

英文

原發性肝惡性腫瘤是亞洲常見疾病但合併膽管癌與肝細胞癌是其中少見之型式。我們有位B型肝炎帶原者具有合併癌。這是一位63歲之男性病患是以大約一個月右上腹痛表現且超音波檢查有一個肝腫瘤存在，電腦斷層與肝血管攝影診斷為一個低血管型腫瘤在肝左葉，懷疑是肝惡性腫瘤存在，所以接受外科手術(左肝葉切除與膽管重建)。術後之病理切片報告為合併膽管癌與肝細胞癌。我們將討論此種病症之診斷及處置並探討相關文獻報告。

While primary hepatic carcinoma is common in Asia, hepatocellular carcinoma (HCC) combined with cholangiocellular carcinoma (CCC) is rare. We present such a case in a hepatitis B carrier. A 63 year-old man was admitted to our hospital with an upper abdominal pain on his right side which had persisted for one month. A hepatic mass was found by abdominal sonography. Computed tomography scan and hepatic arteriography revealed a hypovascular mass with tumor stain in the left hepatic lobe. Based on the values of elevated serum alpha-feto protein (AFP, 893 ng/mL) and CA19-9 (422 U/mL), a preoperative diagnosis of malignant hepatic carcinoma was made. Two separate hepatic masses were found during laparotomy. Lobectomy of the left lobe, resection of the common bile duct and Roux-en-Y hepaticojejunstomy were performed. The histological examination report revealed that the resected tumor consisted of both CCC and HCC.