肝胆管细胞囊腺癌罕见,我们曾遇一例,术前误诊,报告如下。 患者,男,36岁。因肝区疼痛伴发上腹部肿块一个月,腹胀10余天来诊。查体:右上腹局限性隆起,腹壁静脉无怒张,腹肌软无压痛及反跳痛。肝肋下6.0cm,剑突下8.0cm可及,质中,无触痛,表面欠光滑。实验室检查HBsAg阳性,AFP<50μg/L。CT平扫检查于肝右外前方见一约26.5×10.5cm的巨大膨胀性肿块,密度不均匀,内见多个囊状低密度区,中间有粗细不均的条状分隔,部分边缘较毛糙,外侧囊壁上可见小结节影突向囊内,正常肝组织被推压明显变扁,与肿块界限清楚。增强扫描可见条状分隔和囊壁上的结节有轻度强化(见图1,2)。CT诊断:巨块型肝癌。 Hepatobiliary cell cystic adenocarcinoma is rare. We encountered one case and misdiagnosed before surgery. The report is as follows. Patient, male, 36 years old. Due to liver pain associated with abdominal mass for one month, abdominal distension for more than 10 days. Physical examination: Localized uplift of the right upper quadrant, no engorgement of the abdominal wall veins, tenderness of the abdominal muscles without tenderness, and rebound tenderness. Liver ribs 6.0cm, 8.0cm under the xiphoid reach, quality, no tenderness, the surface is less smooth. Laboratory tests positive for HBsAg, AFP <50μg/L. CT scanning showed a massive swelling mass of about 26.5 × 10.5 cm in the right outer front of the liver. The density was uneven, and several cystic low-density areas were seen. There were uneven stripes in the middle, and some of the edges were rougher. The nodules in the lateral cystic wall projected into the sac, and the normal liver tissue was pushed and became flat and clear from the mass. The enhanced scans showed a slight separation between the strips and the nodule on the wall (Fig. 1, 2). CT diagnosis: massive liver cancer.