摘要
目的:分析8例肝胆恶性肿瘤皮肤转移的临床特点及治疗效果.方法:回顾分析我院2006-06/2009-06肝细胞癌2例、混合型肝细胞癌和胆管细胞癌1例及胆管癌5例皮肤转移的临床表现和治疗情况及预后.结果:1例肝细胞癌胆管癌栓并黄疸,经皮经肝胆道引流后20mo皮肤穿刺点种植性转移,皮肤肿瘤切除后已经存活16mo无复发;1例肝细胞癌剖腹探查后9mo切口皮下发现肿瘤,行肝脏左叶切除和切口肿瘤切除后存活8mo;1例混合型肝细胞癌和胆管细胞癌手术切除后4mo多发皮肤转移结节病理检查为胆管细胞癌,化疗后存活3mo;2例胆管癌皮肤单发转移,切除后存后8mo和10mo;3例胆管癌皮肤多发转移患者1例接受化疗存活6mo,2例放弃治疗,分别存活3mo和4mo.结论:为尽量避免肝胆肿瘤种植转移应改进穿刺和切口保护技术;肝胆肿瘤单发皮肤转移可手术治疗并有较好效果,多发皮肤转移应综合治疗,提高生活质量.
AIM：To analyze the clinical characteristics and therapeutic outcomes of 8 cases of hepatobiliary malignancies with cutaneous metastases.
METHODS：From June 2006 to June 2009,eight patients with cutaneous metastases from hepatobiliary malignancies were treated at our hospital.By retrospectively reviewing the clinical data for these patients,the clinical characteristics,treatment and prognosis of this disease were summarized.
RESULTS：One patient with hepatocellular carcinoma（HCC） presenting as obstructive jaundice caused by bile duct tumor thrombi developed cutaneous metastasis at the port site 20 mo after percutaneous transhepatic biliary drainage（PTBD）.The patient had survived 16 mo after resection of the port-site tumor and showed no recurrence.One HCC patient developed tumor at the incision site 9 mo after abdominal exploration.After the skin and liver tumors were excised,the patients survived 8 mo.One patientwith combined HCC and cholangiocellular carcinoma developed multiple cutaneous metastases of cholangiocellular carcinoma and survived 8 mo.Two patients with cholangiocarcinoma and solitary nodular cutaneous metastasis received skin tumor excision and survived 8 and 10 mo,respectively.Of three patients with cholangiocarcinoma and multiple cutaneous metastases,one received chemotherapy and survived 6 mo,and the other 2 refused any treatment and survived 3 and 4 mo,respectively.
CONCLUSION：Puncture and operation procedures should be improved to avoid seeding metastasis.In patients with hepatobiliary malignancies,solitary nodular cutaneous metastasis has a better prognosis,while multiple cutaneous metastases have a worse prognosis.
出处
《世界华人消化杂志》
CAS
北大核心
2010年第20期2166-2170,共5页
World Chinese Journal of Digestology
关键词
肝胆肿瘤
皮肤
转移
Hepatobiliary malignancy
Cutaneous
Metastasis
