青年人非肝硬化肝的高度发育不良结节

Choudry M, Navarro J
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摘要

高级别发育不良结节(HGDN)患者发展为肝细胞癌的风险增加。无肝硬化或纤维化的年轻患者发生肝细胞癌(HCC)是一种相对罕见的疾病。HCC发生在肝硬化患者中,其危险因素与各种病因有关,包括肝炎病毒感染、高酒精摄入量或代谢性疾病。这是一个29岁的男性病例,有7个月的间歇性右上腹疼痛史,CT扫描发现尾状叶肿块伴恶性特征。患者行扩展左肝切除及尾状叶切除术。患者术后第5天出院,并建议在门诊基础上进行随访监测。肝硬化是发生HGDN的主要危险因素,尽管在非肝硬化的年轻患者中罕见的HGDN病例不应被忽视。尽管如此,基于影像学和组织病理学标准很难将HGDN与早期HCC区分开来。早期诊断和适当的手术干预,如解剖切除和定期监测,应考虑在这些患者的过程和管理,尽管其罕见
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High Grade Dysplastic Nodule in a Non-Cirrhotic Liver in the Young
Patients with high grade dysplastic nodule (HGDN) have an increased risk for development of hepatocellular carcinoma. Hepatocellular carcinoma (HCC) in a young patient with no cirrhosis or fibrosis is a relatively rare condition. HCC develops in patients in the setting of liver cirrhosis with established risk factors related to various etiologies including hepatitis virus infection, high alcohol intake or metabolic diseases. This was a case of a 29-year-old male with a 7-month history of intermittent right upper quadrant pain with CT scan findings of caudate lobe mass with malignant features. The patient underwent extended left hepatectomy with caudate lobectomy. Patient was discharged on fifth postoperative day, and was advised for follow-up surveillance on an outpatient basis. Liver cirrhosis is the main risk factor for developing HGDN, although rare cases of HGDN in a non-cirrhotic young patient should not be disregarded. Even though, it difficult to differentiate HGDN from early HCC based on radiologic imaging and histopathological criteria. Early diagnosis accompanied with proper surgical intervention such as anatomic resection and regular surveillance should be considered in the course and management of these patients, despite its rarity
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