肝脏及肝外胆道粘液囊性肿瘤

Dzeina Mezale, Ilze Strumfa, Andrejs Vanags, G. Bahs, B. Štrumfs, Arturs Silovs, R. Riekstins, J. Gardovskis
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引用次数: 4

摘要

肝和肝外胆道的粘液囊性肿瘤最近被世卫组织重新定义为上皮性囊性肿瘤伴卵巢型间充质间质基质。由于这些肿瘤的罕见性以及医疗团队缺乏对其的认识,正确识别这些肿瘤是很困难的。放射学评估,包括超音波,计算机断层扫描,磁共振成像,必要时,正电子发射断层扫描,可以产生正确的诊断。根治性手术切除无肿瘤边缘是治疗的主要方法。适当的治疗方法是非常有益的,可以延长生存时间。在这里,我们讨论最新的定义和分类概念,肿瘤起源的理论观点以及临床表现,诊断,治疗和预后的实际问题。胆管受压[10]或侵犯可导致梗阻性黄疸,易发生上行感染,导致胆管炎。如果肿瘤内容物排入胆管,则可能出现黏液胆道。胆道出血导致胆道出血[51]。根据世卫组织2000年的分类,35%的良性肿瘤(膀胱腺瘤)患者出现胆道症状[10],除了较为典型的缓慢进展的临床表现外,胆道症状还可能是急性表现或间歇性病程。
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Mucinous Cystic Neoplasms of the Liver and Extrahepatic Biliary Tract
Mucinous cystic neoplasms of the liver and extrahepatic biliary tree have recently been re-defined by WHO as epithelial cystic tumours with ovarian-type mesenchymal stroma. Correct recognition of these tumours can be difficult because of their rarity and, conse - quently, lack of awareness by the medical team. Radiological evaluation, including ultra -sonography, computed tomography, magnetic resonance imaging and, upon necessity, positron emission tomography, can yield the correct diagnosis. Radical surgical resection with tumour-free margins is the mainstay of treatment. Adequate treatment approach can be very rewarding, bringing prolonged survival. Here we discuss the up-to-date concepts of definition and classification, theoretical views on tumour origin along with practical issues of clinical presentation, diagnostics, treatment and prognosis. Bile duct compression [10] or invasion can lead to obstructive jaundice and predispose to ascending infection resulting in cholangitis. If the tumour contents are discharged into bile ducts, mucobilia is possible. Bleeding to biliary ways results in haemobilia [ 51 ]. Biliary symp toms are seen in 35% of patients with benign tumours referred to as cystadenomas by WHO classification, 2000 [10] and can be responsible for acute presentation or intermittent course, in addition to the more classical slowly progressing clinical picture.
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Introductory Chapter: Biliary Tree Mucinous Cystic Neoplasms of the Liver and Extrahepatic Biliary Tract Biliary Tract Injuries Multidisciplinary Approach of Malignant Tumors of the Biliary Tree Intrahepatic Cholangiocarcinoma
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