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Case Series of Metastatic Cutaneous Malignant Melanoma to the Gallbladder and the First Reported Case of Metachronous Adenocarcinoma of the Colon 胆囊转移性皮肤恶性黑色素瘤病例系列和首例报告的结肠间变性腺癌病例
Pub Date : 2024-01-18 DOI: 10.29328/journal.acgh.1001044
Kadi Nourdin, Chowdhury Abid, Hanks Matthew, Zaitoun Abed M
Two female patients in their fifties with a previous history of cutaneous malignant melanoma were found during follow-up to have a 'hot' lesion in the gallbladder on a Positron Emission Tomography scan. Imaging showed a gallbladder polyp. Histology revealed infiltration of the polyp mucosa by metastatic malignant melanoma. One case had a BRAF mutation. A male in his 70s was found on a staging computed tomography scan to have a suspicious intraluminal lesion in the gallbladder and thickening of the sigmoid colon. Subsequent histology confirmed metastatic malignant melanoma in the chest wall and to the gallbladder and adenocarcinoma in the colon. Molecular testing showed BRAF mutation. The metachronous adenocarcinoma in the colon was mismatch repair protein proficient and had no KRAS mutation. Histology from all cases showed that metastatic malignant melanoma to the gallbladder is superficial. Discussion: Reports from autopsy examinations revealed that metastasis from malignant melanoma to the gallbladder can be up to 15% - 20%. Most patients have mild symptoms or are asymptomatic which explains the paucity of cases reported in living patients within the published literature. Most of the previous reports showed the metastatic malignant melanoma to the gallbladder presented macroscopically as a polyploidal lesion. Conclusion: Our histological observation and previous reports showed that metastatic malignant melanoma in the gallbladder tends to be superficial. All our cases show no lymphatic or vascular invasion in the histological examination as previously published reports, however, the hematological spread is the most commonly suggested mechanism of spread.
两名五十多岁的女性患者既往有皮肤恶性黑色素瘤病史,在随访过程中,她们在正电子发射断层扫描中发现胆囊内有一个 "热 "病灶。造影显示胆囊息肉。组织学检查发现息肉粘膜被转移性恶性黑色素瘤浸润。其中一例有 BRAF 基因突变。一名 70 多岁的男性在分期计算机断层扫描中发现胆囊有可疑的腔内病变,乙状结肠增厚。随后的组织学检查证实胸壁和胆囊有转移性恶性黑色素瘤,结肠有腺癌。分子检测显示 BRAF 基因突变。结肠中的转移性腺癌缺乏错配修复蛋白,也没有 KRAS 突变。所有病例的组织学检查都显示,转移到胆囊的恶性黑色素瘤是表浅的。讨论:尸检报告显示,恶性黑色素瘤转移到胆囊的比例高达 15%-20%。大多数患者症状轻微或无症状,这也是已发表文献中鲜有活体病例报道的原因。之前的大多数报告显示,转移至胆囊的恶性黑色素瘤在宏观上表现为息肉样病变。结论我们的组织学观察结果和以往的报道显示,转移至胆囊的恶性黑色素瘤多为浅表性。我们所有的病例在组织学检查中均未发现淋巴或血管侵犯,这与之前发表的报告相同,但血液学扩散是最常见的扩散机制。
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引用次数: 0
Prospective Coronavirus Liver Effects: Available Knowledge 冠状病毒对肝脏的潜在影响:现有知识
Pub Date : 2023-08-18 DOI: 10.29328/journal.acgh.1001039
Mandal Avishek
The global pandemic COVID-19, caused by SARS-CoV-2, affected millions of people. COVID-19 is known for its respiratory symptoms, but new research reveals it may also affect other organ systems, including the liver. This abstract reviews COVID-19 and liver function. The virus enters host cells through liver-expressed angiotensin-converting enzyme 2 (ACE2) receptors. Thus, viral infection and replication may target the liver. Virus-induced inflammation and cytokine production may also harm the liver. ALT and AST elevations are the most prevalent liver abnormalities in COVID-19 patients. Liver function test abnormalities frequently indicate serious illness and poor clinical outcomes. COVID-19 may worsen pre-existing liver diseases such as NAFLD and chronic viral hepatitis. Drug-induced liver damage (DILI) from COVID-19 therapies including antivirals and corticosteroids complicates liver complications care. Recent investigations have also shown that COVID-19 may cause long-term liver damage. In conclusion, COVID-19 infection, immune-mediated damage, and treatment problems may severely compromise liver function. Optimizing patient treatment and discovering targeted medicines requires understanding COVID-19's liver role. To reduce the effects of COVID-19 on liver function, further study is required to understand the mechanisms and long-term effects.
由SARS-CoV-2引起的全球大流行COVID-19影响了数百万人。COVID-19以其呼吸道症状而闻名,但新的研究表明,它也可能影响包括肝脏在内的其他器官系统。本文综述了COVID-19与肝功能的关系。病毒通过肝脏表达的血管紧张素转换酶2 (ACE2)受体进入宿主细胞。因此,病毒感染和复制可能以肝脏为目标。病毒引起的炎症和细胞因子的产生也可能损害肝脏。ALT和AST升高是COVID-19患者中最常见的肝脏异常。肝功能检查异常往往预示着严重的疾病和不良的临床结果。COVID-19可能会加重NAFLD和慢性病毒性肝炎等已有肝脏疾病。包括抗病毒药物和皮质类固醇在内的COVID-19治疗引起的药物性肝损伤(DILI)使肝脏并发症护理复杂化。最近的调查还表明,COVID-19可能导致长期肝损伤。总之,COVID-19感染、免疫介导的损伤和治疗问题可能严重损害肝功能。优化患者治疗和发现靶向药物需要了解COVID-19的肝脏作用。为了减少COVID-19对肝功能的影响,需要进一步研究其机制和长期影响。
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引用次数: 0
Jejunal adenocarcinoma, a rare cancer of the gastrointestinal tract: a comprehensive review discussion epidemiology 空肠腺癌,一种罕见的胃肠道肿瘤:流行病学综述
Pub Date : 2022-11-24 DOI: 10.29328/journal.acgh.1001037
Mohammed Abdul, K. Prabhat, P. Neethi, Sritharan Nithya, Waghray Nisheet
1Department of Gastroenterology and Hepatology, AdventHealth, Orlando, FL, USA 2Department of Internal Medicine, Cleveland Clinic Fairview Hospital, Cleveland OH, 44111, USA 3Department of Hematology & Oncology, Rochester General Hospital, 1425 Portland Ave, Rochester, NY, 14621, USA 4Division of Gastroenterology and Hepatology, Metro Health Medical center, Case Western Reserve University, 2500 Metrohealth Drive, Cleveland, OH, 44109, USA More Information
1消化内科和肝病科,AdventHealth,奥兰多,佛罗里达州,美国2内科,克利夫兰诊所Fairview医院,克利夫兰,44111,美国3血液和肿瘤科,罗切斯特总医院,1425波特兰大道,罗切斯特,纽约州,14621,美国4消化内科和肝病科,Metro健康医疗中心,凯斯西储大学,2500 Metrohealth Drive,克利夫兰,OH, 44109,美国更多信息
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引用次数: 0
A case of coexistent acute severe alcoholic and Q fever hepatitis: The useful contribution of repeated liver biopsies 急性重度酒精性肝炎与Q热性肝炎合并1例:反复肝活检的有益贡献
Pub Date : 2022-09-23 DOI: 10.29328/journal.acgh.1001036
Zampaglione Lucia, Bornand Aurélie, Goossens Nicolas, Ramer Lucas, Magini Giulia, Ongaro Marie, Cerny Andreas, Rubbia-Brandt Laura, J. Frossard, Spahr Laurent
Acute Q fever is a worldwide zoonotic infection due to C. burnetii that may be associated with hepatitis. Nonspecific clinical and biological manifestations may accompany liver involvement, including hepatomegaly and elevated liver biological tests. However, the presence of jaundice is rare. Therefore, making a diagnosis of Q fever hepatitis may be difficult in an afebrile patient with jaundice of recent onset, altered liver function tests, excessive alcohol intake and no reported contact with animals. We report here the diagnostic work-up and complex clinical management of a patient presenting with acute hepatitis resulting from both C. burnetii infection and severe alcoholic steatohepatitis. Positive serology together with a detailed examination of the liver biopsy was able to reveal the coexistence of both Q fever hepatitis with typical fibrin-ring granulomas as well as florid lesions of alcoholic steatohepatitis. A combination of antibiotics, hydroxychloroquine and steroids, guided by the helpful description of changes in histological alterations on repeated liver biopsies during the course of the disease contributed to the slow but favorable outcome.
急性Q型热是一种世界性的人畜共患感染,由伯氏胞杆菌引起,可能与肝炎有关。非特异性临床和生物学表现可伴随肝脏受累,包括肝肿大和肝生物学检查升高。然而,黄疸的存在是罕见的。因此,对于近期出现黄疸、肝功能检查改变、过量饮酒且未报告与动物接触的发热患者,可能难以诊断为Q型发热性肝炎。我们在这里报告诊断检查和复杂的临床管理的病人提出急性肝炎由伯纳蒂胞杆菌感染和严重酒精性脂肪性肝炎。阳性血清学和肝脏活检的详细检查能够揭示Q型肝炎与典型纤维蛋白环肉芽肿以及酒精性脂肪性肝炎的红肿病变共存。抗生素、羟氯喹和类固醇的联合治疗,在疾病过程中反复肝活检的组织学改变的有用描述的指导下,有助于缓慢但有利的结果。
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引用次数: 0
Correlation of dyslipidemia and athrogenic index of plasma with anthropometric measurements and clinical variables among diabetic patients in Dessie Comprehensive Specialized Hospital, Ethiopia, 2021 埃塞俄比亚Dessie综合专科医院糖尿病患者血脂异常和血浆动脉粥样硬化指数与人体测量和临床变量的相关性
Pub Date : 2022-07-14 DOI: 10.29328/journal.acgh.1001035
Wuhib Mekuriaw, T. Belachew, Mekonnen Leul, Mengesha Zemen, Girma Mitaw, S. Mamo, Wuhib Getachew
Background: Control of increased athrogenic index of plasma and lipid parameters in the early stage of diabetes mellitus helps diabetic patients to improve their quality of life and treatment outcomes. Limited studies were conducted on the assessment of dyslipidemia and its correlation with clinical and anthropometric variables among diabetes patients but no study was conducted on the correlation of the athrogenic index of plasma with anthropometric measurements among diabetes patients in this study area. The objective of this study was to assess the correlation of dyslipidemia and athrogenic index of plasma with anthropometric measurements and clinical variables among diabetic patients in Dessie Compressive Specialized Hospital, Northeast Ethiopia. Methods: Institution-based comparative cross-sectional study was conducted from August 2020 to June 2021. A total of 250 diabetic and healthy control respondents were included in the study with convenience sampling. Semi-structured questionnaire of a modified WHO stepwise Approach to Surveillance for chronic disease was used to collect data. Finally, descriptive statistics and correlation analysis were conducted to assess the correlation between variables. A p - value of less than 0.05 was declared as the level of significance. Results: Athrogenic Index of Plasma, Triglyceride to High-density Lipoprotein Ratio, Very-Low-Density Lipoprotein, systolic blood pressure, diastolic blood pressure, triglyceride, waist circumference, WHtR and BMI were statistically significantly higher among Type 2 DM groups. There was a significant positive linear correlation between triglycerides and waist circumference, between TG/HDL and WHtR, and between cholesterol and WHtR, but a significant negative linear correlation between HDL and waist circumference among the Type 2 DM group. Systolic blood pressure and pulse showed a significant positive linear correlation with WC, BMI, and WHtR among diabetics groups only. Our study showed that the pattern of lipid abnormalities observed among DM patients was high AIP in 68%, moderate AIP in 16% and all four groups of hyperlipidemia were found in 9% of diabetic patients. All lipid profiles showed a significant very strong positive linear correlation with AIP, but DHL has a significant very strong negative linear correlation with AIP among Type 2 DM groups. Conclusion: The proportions of high athrogenic index of plasma and lipid profile disorders were higher in DM patients compared to healthy controls. Dyslipidemia and a high athrogenic index of plasma had a considerable correlation with anthropometric measurements and clinical outcomes of Type 2 DM patients. DM patients who have a higher athrogenic index of plasma and higher lipid parameters should be strictly followed based on their anthropometric measurements.
背景:控制糖尿病早期血浆和脂质参数的动脉粥样硬化指数升高有助于改善糖尿病患者的生活质量和治疗效果。对糖尿病患者血脂异常及其与临床和人体测量变量的相关性进行了有限的研究,但未对本研究区糖尿病患者血浆动脉粥样硬化指数与人体测量指标的相关性进行研究。本研究的目的是评估血浆血脂异常和动脉粥样硬化指数与埃塞俄比亚东北部Dessie压缩专科医院糖尿病患者的人体测量和临床变量的相关性。方法:于2020年8月至2021年6月进行基于机构的比较横断面研究。采用方便抽样的方法,将250名糖尿病患者和健康对照者纳入研究。采用改进的世卫组织逐步监测慢性病方法的半结构化问卷收集数据。最后,通过描述性统计和相关分析来评估变量之间的相关性。p值小于0.05为显著性水平。结果:血浆粥样硬化指数、甘油三酯/高密度脂蛋白比、极低密度脂蛋白、收缩压、舒张压、甘油三酯、腰围、WHtR、BMI在2型DM组中均有统计学意义。2型DM组甘油三酯与腰围、TG/HDL与WHtR、胆固醇与WHtR呈显著的线性正相关,而HDL与腰围呈显著的线性负相关。仅在糖尿病组中,收缩压和脉搏与WC、BMI和WHtR呈显著的线性正相关。我们的研究表明,糖尿病患者的脂质异常模式为高AIP占68%,中度AIP占16%,四组高脂血症均出现在9%的糖尿病患者中。2型DM组各血脂与AIP呈显著的极强正线性相关,而DHL与AIP呈显著的极强负线性相关。结论:糖尿病患者血浆及血脂异常的高致动脉粥样硬化指数比例高于健康对照组。血脂异常和高血浆动脉粥样硬化指数与2型糖尿病患者的人体测量和临床结果有相当大的相关性。血浆动脉粥样硬化指数和血脂参数较高的糖尿病患者应根据其人体测量值严格遵循。
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引用次数: 0
Laparoscopic surgical treatment of median arcuate ligament syndrome with the retrograde division technique: a case report 腹腔镜下逆行分割技术治疗正中弓状韧带综合征1例
Pub Date : 2022-05-18 DOI: 10.29328/journal.acgh.1001034
Yetisir Fahri, Babayeva Afruz, Güzel Kerim
Median arcuate ligament syndrome is a rare entity. This clinical condition develops by compression of the root of a celiac artery with the median arcuate ligament. The typical triad of this syndrome is the following; abdominal discomfort and pain, especially after a meal, and weight loss. In diagnosis, other causes should be ruled out and compression must be demonstrated by any type of imaging method. The main principle of treatment is cutting down the median arcuate ligament. A 54-year-old woman presented with untreatable recurrent abdominal pain and was diagnosed with median arcuate ligament syndrome by imaging with angiographic computed tomography. This patient was operated on. We performed laparoscopic division of median arcuate ligament with the retrograde surgical dissection technique. The patient was discharged from the hospital without any complaint on the third day after surgery. She was still symptom-free after 12 months. The laparoscopic retrograde dissection approach is a safe and feasible treatment modality for median arcuate ligament syndrome.
正中弓状韧带综合征是一种罕见的疾病。这种临床病症是由于正中弓状韧带压迫腹腔动脉根而发生的。这种综合征的典型三联征如下;腹部不适和疼痛,特别是饭后,和体重下降。在诊断时,应排除其他原因,并必须通过任何类型的成像方法证明压迫。治疗的主要原则是切断正中弓状韧带。一名54岁女性,因复发性腹痛无法治愈,经血管造影计算机断层扫描诊断为正中弓状韧带综合征。这个病人做了手术。我们采用逆行手术分离技术进行腹腔镜正中弓状韧带分离。患者于术后第三天无主诉出院。12个月后,她仍无症状。腹腔镜逆行夹层入路是治疗正中弓状韧带综合征的一种安全可行的方法。
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引用次数: 0
Treatment of perianal fistulae in crohn's disease with mesenchymal stem cells 间充质干细胞治疗克罗恩病肛周瘘
Pub Date : 2022-05-04 DOI: 10.29328/journal.acgh.1001033
Chairi Mohamed Hassin Mohamed, Peña Francisco José Huertas, Zurbano Marta Santidrián, Alcalá Tomás Torres, del Moral Jesús María Villar
Crohn's disease is a chronic syndrome of the gastrointestinal tract that produces idiopathic inflammation. Approximately half of the patients develop abscesses and/or fistulas throughout their history that are located, mainly, in the perianal region. Current treatments are based on individualized plans that generally use combined pharmacology for symptomatic relief based on glucocorticoids, immunosuppressants or immunomodulators, antibiotics, anti-inflammatories, probiotics, and antibodies, or surgical therapies such as intestinal resections or ostomizations (colostomy and ileostomy) that tend to cause notable side effects in a considerable percentage of patients and a significant decrease in their quality of life. Perianal fistulas consist of abnormal tracts, inflammatory tunnels, or chronic tracts of granular tissue that connect two surfaces lined with epithelium, have an external hole in the skin that borders the anus, and an internal hole located inside it around the anal canal, rectus and sphincters. Treatment is a complex process that requires a multidisciplinary approach and the combination of several treatments. In the short term, the goal is to drain abscesses, reduce inflammatory and infectious processes, guard the fistulous tract with seton or lax lines, facilitate patency, and hinder new formations. In the long term, a total cure and the avoidance of complications that require surgery or the creation of intestinal stomas are pursued. For this reason, new effective remedies with fewer adverse effects continue to be investigated, one of the most promising being the use of mesenchymal stem cells for the regeneration and cure of perianal fistulas and the remission of symptoms. The present bibliographic review delves into this new therapy and analyzes the current state of the situation regarding its efficacy and safety.
克罗恩病是一种产生特发性炎症的胃肠道慢性综合征。大约一半的患者在其病史中出现脓肿和/或瘘管,主要位于肛周区域。目前的治疗是基于个体化的方案,通常使用基于糖皮质激素、免疫抑制剂或免疫调节剂、抗生素、抗炎药、益生菌和抗体的联合药物治疗来缓解症状,或手术治疗,如肠道切除或造口术(结肠造口术和回肠造口术),这些治疗往往会在相当大比例的患者中引起明显的副作用,并显著降低他们的生活质量。肛周瘘管由异常瘘管、炎性瘘管或颗粒组织的慢性瘘管组成,这些颗粒组织连接有上皮的两个表面,在与肛门接壤的皮肤上有一个外孔,在肛门内有一个内孔,位于肛管、直肌和括约肌周围。治疗是一个复杂的过程,需要多学科的方法和几种治疗方法的结合。短期内,目的是引流脓肿,减少炎症和感染过程,用粗糙或松弛的线保护瘘道,促进通畅,并阻止新的形成。从长远来看,完全治愈和避免并发症需要手术或肠造口是追求。由于这个原因,新的有效的治疗方法和更少的不良反应继续被研究,其中最有希望的是使用间充质干细胞再生和治疗肛周瘘管和缓解症状。本文献综述深入研究了这种新疗法,并分析了其有效性和安全性的现状。
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引用次数: 0
Pitfalls in the hemostatic management of a liver transplantation 肝移植止血处理中的陷阱
Pub Date : 2022-04-13 DOI: 10.29328/journal.acgh.1001032
Y. Raveh, R. Nicolau‐Raducu
Liver Transplantation is fraught with thrombo-hemorrhagic complications, due to the precarious hemostasis of the recipient, anhepatic conditions, and the release of hemostatic factors from the allograft. Disseminated intravascular coagulation and its “flat-line” variant are common causes of hemorrhage and thrombosis, and frequently force the clinician along with a delicate balance between hemorrhage and thrombosis. We present a case that highlights some of the more challenging diagnostic and management decisions in liver transplantation and presents a safe and carefully structured approach to hyperfibrinolysis in liver transplantation.
由于受体不稳定的止血、无肝条件和同种异体移植物释放的止血因子,肝移植充满了血栓出血并发症。弥散性血管内凝血及其“平线”变异是出血和血栓形成的常见原因,常常迫使临床医生在出血和血栓形成之间保持微妙的平衡。我们提出了一个病例,强调了肝移植中一些更具挑战性的诊断和管理决策,并提出了一种安全且精心构建的肝移植中高纤溶的方法。
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引用次数: 0
Diffuse large B-cell Lymphoma mimicking as cholangiocarcinoma in a young male presenting with obstructive jaundice 弥漫大b细胞淋巴瘤模拟胆管癌的年轻男性表现为梗阻性黄疸
Pub Date : 2021-10-12 DOI: 10.29328/journal.acgh.1001031
D. Muhammad, Khan Shoaib Ahmed, Samoon Dilnawaz, Majid Zain, H. Farina, Tassneem Abbas Ali, Luck Nasir Hasan
The involvement of bile duct in lymphoma is considered to be very rare and is usually a sequela of a disseminated disease [1]. In contrast to secondary involvement, primary non-Hodgkin’s lymphoma arising from the bile duct is extremely rare and presents with obstructive jaundice [2,3]. Non-Hodgkin’s lymphoma (NHL) accounts for 1% - 2% of all cases of malignant biliary obstruction [4]. Hepatobiliary involvement by malignant lymphoma is usually a secondary manifestation of systemic lymphoma. The first case of Non-Hodgkin lymphoma arising from bile duct was described by Nguyen in 1982 [5]. Most common extra nodal involvement of NHL is abdomen. Although, involvement of the stomach, pancreas or common bile duct is not common [6]. We present to you a case of 31year old male who presented to us with obstructive jaundice and was later diagnosed as Diffuse Large B-Cell lymphoma.
淋巴瘤累及胆管被认为是非常罕见的,通常是播散性疾病的后遗症[1]。与继发性累及相比,起源于胆管的原发性非霍奇金淋巴瘤极为罕见,表现为梗阻性黄疸[2,3]。非霍奇金淋巴瘤(Non-Hodgkin’s lymphoma, NHL)占所有恶性胆道梗阻病例的1% - 2%[4]。恶性淋巴瘤累及肝胆通常是全身性淋巴瘤的继发表现。首例胆管非霍奇金淋巴瘤由Nguyen于1982年报道[5]。NHL最常见的淋巴结外受累是腹部。虽然,累及胃、胰腺或胆总管并不常见[6]。我们向您报告一例31岁男性患者,他向我们提出梗阻性黄疸,后来被诊断为弥漫性大b细胞淋巴瘤。
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引用次数: 0
Giant hepatic cystadenoma mimicking a hydatid cyst: A challenging preoperative diagnosis 巨大肝囊腺瘤模拟包虫囊肿:一个具有挑战性的术前诊断
Pub Date : 2021-03-24 DOI: 10.29328/JOURNAL.ACGH.1001027
Mosaab Ghannouchi, Amina Chaka, S. Hammouda, M. Khalifa, A. Chaouech, K. Nacef, Kamel Hleli, M. Boudokhane
Biliary cystadenoma is a rare cystic tumor of the liver. It has a high recurrence rate and malignant transformation risk in middle-aged women. Pre-operative diagnosis is difficult because of the lack of clinical, biological and radiological specificity. The confirmation of the diagnosis is made by the histopathological examination. Complete surgical resection is preferred because of the high risk of malignant transformation and recurrence.
胆道囊腺瘤是一种罕见的肝脏囊性肿瘤。在中年妇女中有较高的复发率和恶性转化的危险。术前诊断是困难的,因为缺乏临床,生物学和放射学特异性。诊断的确认是通过组织病理学检查作出的。完全手术切除是首选,因为恶性转化和复发的风险高。
{"title":"Giant hepatic cystadenoma mimicking a hydatid cyst: A challenging preoperative diagnosis","authors":"Mosaab Ghannouchi, Amina Chaka, S. Hammouda, M. Khalifa, A. Chaouech, K. Nacef, Kamel Hleli, M. Boudokhane","doi":"10.29328/JOURNAL.ACGH.1001027","DOIUrl":"https://doi.org/10.29328/JOURNAL.ACGH.1001027","url":null,"abstract":"Biliary cystadenoma is a rare cystic tumor of the liver. It has a high recurrence rate and malignant transformation risk in middle-aged women. Pre-operative diagnosis is difficult because of the lack of clinical, biological and radiological specificity. The confirmation of the diagnosis is made by the histopathological examination. Complete surgical resection is preferred because of the high risk of malignant transformation and recurrence.","PeriodicalId":252959,"journal":{"name":"Annals of Clinical Gastroenterology and Hepatology","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122084158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Annals of Clinical Gastroenterology and Hepatology
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