We report a case of a 56-year-old woman with intrahepatic biliary cystadenoma(IBC)accompanying a tumor embolus in the extrahepatic bile duct,who was admitted to our department on October 13,2008.Imaging showed an asym...We report a case of a 56-year-old woman with intrahepatic biliary cystadenoma(IBC)accompanying a tumor embolus in the extrahepatic bile duct,who was admitted to our department on October 13,2008.Imaging showed an asymmetry dilation of the biliary tree,different bile signals in the biliary tree,a multiloculated lesion and an extrahepatic bile duct lesion with internal septation.A regular left hemihepatectomy en bloc was performed with resection of the entire tumor,during which a tumor embolus protruding into the extrahepatic bile duct and originating from biliary duct of segment 4 was revealed.Microscopically,the multiloculated tumor was confirmed to be a biliary cystadenoma with an epithelial lining composed of biliary-type cuboidal cells and surrounded by an ovarian-like stroma.An aggressive en bloc resection was recommended for the multiloculated lesion.Imaging workup,clinicians and surgeons need to be aware of this different presentation.展开更多
Background:Transarterial chemoembolization(TACE)and percutaneous microwave coagulation therapy(PMCT)are commonly used to treat intrahepatic recurrent liver cancers.However,there is no informa-tion regarding their effe...Background:Transarterial chemoembolization(TACE)and percutaneous microwave coagulation therapy(PMCT)are commonly used to treat intrahepatic recurrent liver cancers.However,there is no informa-tion regarding their effectiveness in patients with recurrent intrahepatic cholangiocarcinoma(ICC)after resection.Methods:A total of 275 patients with localized recurrent ICC who received either TACE(n=183)or PMCT(n=92)were studied.A propensity score matching analysis was performed to compare prognostic impact of TACE and PMCT.Prognostic factors for TACE and PMCT were identified respectively.Predictive nomograms for each TACE and PMCT were developed using the Cox independent prognostic factors and were validated in independent patient groups by receiver operating characteristic curves and area under curve values.Results:Both TACE and PMCT provided curativeness in partial patients(5-year overall survival:21.4%and 6.1%,respectively),but TACE provided better survival benefit in both overall patients(hazard ratio[HR]=0.71;95%confidence interval[CI]:0.50–0.97;P=0.034)and propensity score matching analysis(HR=0.69;95%CI:0.47–0.98;P=0.041).Independent prognostic factors for TACE were tumor size>5 cm,poor differentiation,and major resection,whereas poor differentiation,hepatitis B virus infection,cholelithiasis,and lymph node metastasis were identified for PMCT.Both predictive nomograms for TACE and PMCT were validated to be effective with area under curve values of 0.77 and 0.70,respectively.Conclusions:TACE provided better survival benefits compared to PMCT.However,there was a disparity in prognostic factors,suggesting evaluation of the two nomograms may be supportive in modality selection.Further prospective validation studies are required for the results to be applied in clinical medicine.展开更多
文摘We report a case of a 56-year-old woman with intrahepatic biliary cystadenoma(IBC)accompanying a tumor embolus in the extrahepatic bile duct,who was admitted to our department on October 13,2008.Imaging showed an asymmetry dilation of the biliary tree,different bile signals in the biliary tree,a multiloculated lesion and an extrahepatic bile duct lesion with internal septation.A regular left hemihepatectomy en bloc was performed with resection of the entire tumor,during which a tumor embolus protruding into the extrahepatic bile duct and originating from biliary duct of segment 4 was revealed.Microscopically,the multiloculated tumor was confirmed to be a biliary cystadenoma with an epithelial lining composed of biliary-type cuboidal cells and surrounded by an ovarian-like stroma.An aggressive en bloc resection was recommended for the multiloculated lesion.Imaging workup,clinicians and surgeons need to be aware of this different presentation.
基金supported by grants from the National Natural Science Foundation of China(81902939)Startup Fund for Young Teacher from Shanghai Jiaotong University(KJ3-0214-18-0022).
文摘Background:Transarterial chemoembolization(TACE)and percutaneous microwave coagulation therapy(PMCT)are commonly used to treat intrahepatic recurrent liver cancers.However,there is no informa-tion regarding their effectiveness in patients with recurrent intrahepatic cholangiocarcinoma(ICC)after resection.Methods:A total of 275 patients with localized recurrent ICC who received either TACE(n=183)or PMCT(n=92)were studied.A propensity score matching analysis was performed to compare prognostic impact of TACE and PMCT.Prognostic factors for TACE and PMCT were identified respectively.Predictive nomograms for each TACE and PMCT were developed using the Cox independent prognostic factors and were validated in independent patient groups by receiver operating characteristic curves and area under curve values.Results:Both TACE and PMCT provided curativeness in partial patients(5-year overall survival:21.4%and 6.1%,respectively),but TACE provided better survival benefit in both overall patients(hazard ratio[HR]=0.71;95%confidence interval[CI]:0.50–0.97;P=0.034)and propensity score matching analysis(HR=0.69;95%CI:0.47–0.98;P=0.041).Independent prognostic factors for TACE were tumor size>5 cm,poor differentiation,and major resection,whereas poor differentiation,hepatitis B virus infection,cholelithiasis,and lymph node metastasis were identified for PMCT.Both predictive nomograms for TACE and PMCT were validated to be effective with area under curve values of 0.77 and 0.70,respectively.Conclusions:TACE provided better survival benefits compared to PMCT.However,there was a disparity in prognostic factors,suggesting evaluation of the two nomograms may be supportive in modality selection.Further prospective validation studies are required for the results to be applied in clinical medicine.
