肝胆管内乳头状肿瘤1例

Beltaifa Dorsaf, Slama Sana Ben, Guebsi Sofiene, A. Aziz, Arfa Nafaa, L. Ahlem, Bacha Dhouha
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引用次数: 0

摘要

导言:胆管内乳头状肿瘤(IPNB)是一种罕见的实体,其特征是胆管外生性生长。病例介绍:在此报告中,我们报告了一名57岁男性,无病史咨询,右上腹痛,黄疸和瘙痒。进行腹部超声(US)和磁共振成像/胆汁-磁共振检查。他们发现肝总管的周向壁增厚延伸了约4cm,左侧肝内胆管适度扩张。计算机断层扫描未显示远处转移的证据。活检显示高级别导管内乳头状肿瘤。40天后,患者行左肝切除术,切除主胆管和胆囊。手术标本的肉眼检查显示脐处有扩张管,管壁增厚。组织病理学报告显示,多发肝内乳头状肿瘤伴高级别不典型增生,左肝管浸润性癌成分,未扩展到胆管壁,分类为pT1N0。结论:该癌前病变如诊断不当,有可能转变为浸润性癌。我们的病例说明了早期识别如何导致潜在的手术切除。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A case of hepatic intraductal papillary neoplasm of the bile duct
Introduction: Intraductal Papillary Neoplasm of the Bile ducts (IPNB) is a rare entity characterized by exophytic growth of the bile ducts. Case presentation: In this report, we present a 57-year-old male with no prior medical history consulted for upper right abdominal pain, jaundice and pruritus. Abdominal Ultrasound (US) and magnetic resonance imaging/Bili-magnetic resonance were performed. They revealed that the circumferential parietal thickening of the common hepatic duct had extended approximately 4 cm with moderate dilatation of the left intrahepatic bile ducts. Computed tomography showed no evidence of distant metastasis. Biopsy revealed a high-grade intraductal papillary neoplasm. After 40 days, the patient had left hepatectomy with resection of the main bile duct and the gallbladder. Macroscopic examination of the surgical specimen showed a dilatation duct at the hilum with thickening of their walls. The histopathology report revealed multiple intra-hepatic papillary neoplasms with high-grade dysplasia with an invasive carcinoma component in the left hepatic duct without extending to the biliary wall, classified as pT1N0. Conclusion: This premalignant lesion has the potential to transform into invasive carcinoma if not properly diagnosed. Our case illustrates how early identification can lead to potential surgical resection.
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