<症例>小胆嚢癌およびその孤立性肝転移の1切除例

概要

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A 72-year-old female was incidentally found to have a mass in the right lobe of the liver on ultrasonogram of the abdomen during examinations of her diabetes mellitus. The mass was suspected of being the metastatic carcinoma of the liver by additional imaging modalities. A 10×8 mm sized elevated lesion in the gallbladder was also demonstrated on ultrasonogram of the abdomen and endoscopic retrograde cholangiopancreatography. Thence, with a tentative diagnosis of gallbladder carcinoma and its solitary hepatic metastasis, the patient underwent cholecystectomy and complete resection of the hepatic mass. The gallbladder lesion revealed a histology of well differentiated adenocarcinoma, which was also demonstrated in the hepatic mass. No direct communication was, however, evidenced between the gallbladder carcinoma and the hepatic metastasis. Severe inflammation and nests of relatively undifferentiated carcinoma were found along the wall of cystic portion of the metastasis suggesting the presence of a so-called necrotic hepatic metastasis. The patient has been alive and well for 7 months since the surgery without evidence of recurrence of the carcinoma. Although the prognosis of advanced gallbladder carcinoma is usually miserable, it may be expected to gain the longer survival when an adequate surgery is carried out for patients having a resectable hepatic metastasis.
近畿大学の論文
1986-09-25