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目的探讨肝胆恶性肿瘤出现皮肤转移患者临床特征。方法选取肝胆恶性肿瘤出现皮肤转移的患者8例,均为2013年5月至2015年5月收治,分析其临床特征及预后。结果 1例肝细胞癌在剖腹探查时,受出血原因的影响,仅取病理组织检查,10个月后,检出切口皮下有2.5cm×2.5cm的肿瘤,行切口肿瘤切除和肝脏左叶切除后,存活时间为9个月;1例肝门部胆管癌,采取根治切除手术治疗后2个月,发现上肢、头皮、双肺皮肤出现多发转移的情况,患者放弃治疗自行离院,存活时间为3个月;1例肝门部胆管癌,颈部检出皮肤单发肿瘤,随访示存活时间为10个月;1例胆管细胞癌和混合型肝细胞癌,皮肤多发转移,细针穿刺皮肤结果,病检结果为胆管细胞癌,实施化疗治疗,存活时间为3个月;1例肝细胞癌胆管癌栓与梗阻性黄疸合并发生,对皮肤穿刺点观察,有类圆形结节检出,切除皮肤肿瘤后,存活时间已有15个月,未出现复发情况;1例肝门部胆管癌,到院就诊时,右大腿检出皮肤单发肿瘤,随访示存活时间为9个月。结论为防范肝胆肿瘤发生皮肤种植转移,需对切口保护技术和穿刺技术改进,针对肝胆肿瘤发生单发皮肤转移的病例,可应用手术方案治疗,可取得理想成效,针对多发皮肤转移,需采取综合治疗手段,以保障患者生存质量。
Objective To investigate the clinical features of patients with cutaneous metastasis of hepatobiliary malignancies. Methods Eight patients with hepatocellular carcinoma who had skin metastasis were selected. All patients were treated from May 2013 to May 2015 and their clinical characteristics and prognosis were analyzed. Results One case of hepatocellular carcinoma undergoing exploratory laparotomy was affected by the cause of bleeding. Only pathological examination was performed. Ten months later, a 2.5 cm × 2.5 cm tumor was examined subcutaneously, and resection of the tumor and excision of the left lobe of liver , Survival time was 9 months; 1 case of hilar cholangiocarcinoma, radical resection surgery 2 months after the discovery of upper extremity, scalp, lung skin showed multiple metastases, the patient abandon the treatment of leaving their homes, survival time For 3 months; 1 case of hilar cholangiocarcinoma, single skin tumor detected in the neck, survival time was 10 months follow-up; 1 case of cholangiocarcinoma and mixed hepatocellular carcinoma, multiple skin metastasis, fine needle aspiration Skin results, the results of pathological examination of cholangiocarcinoma, the implementation of chemotherapy, survival time was 3 months; 1 case of hepatocellular carcinoma cholangiocarcinoma embolization and obstructive jaundice occurred, the skin puncture point observation, a class of round nodules Out of the skin tumor, the survival time has been 15 months, no recurrence; 1 case of hilar cholangiocarcinoma, to the hospital, the right thigh skin single tumor detection, follow-up showed a survival time of 9 months . Conclusion In order to prevent the metastasis of hepatocellular carcinoma, it is necessary to improve the technique of incision protection and puncture technique. For the case of single skin metastasis of hepatobiliary tumor, it can be treated with surgical regimen and can achieve the desired result. For multiple skin metastasis, Treatment, in order to protect the quality of patient’s life.