肝细胞腺瘤36例临床分析

目的 探讨肝细胞腺瘤(HCA)的准确诊断及合理治疗方法.方法 回顾性分析近3年来收治的36例HCA患者的临床、病理、影像学资料及治疗效果.结果 大多数HCA患者无明显症状,血清学检查正常.病理显示局部癌变1例,瘤内出血坏死19例,其中1例肿瘤破裂出血至腹腔.大多数病灶CT、MRI增强扫描后动脉期病灶均匀强化,门静脉、延迟期造影剂退出.手术切除疗效确切.结论 HCA无特异性临床表现,CT、MRI增强扫描对HCA有较高的诊断价值;因其可发生破裂出血及癌变,故对怀疑HCA者手术切除是首选的治疗方法.

HEPATOCELLULAR ADENOMA A CLINICAL STUDY OF 36 CASES

Objective To study the diagnosis and proper treatment of hepatocellular adenoma(HCA).Methods Clinical,pathological data,preoperative imaging findings and treatment outcome of 36 cases admitted into our hospital during recent 3 years were retrospectively analyzed. Results Most of the patients were asymptomatic and serum test was normal.Foci of carcinoma was disclosed in one patient.19 patients(52.8%) had evidence of intratumoral hemorrhage,among which 1 patients were admitted with intraperitoneal tumoral rupture.On dynamic CT or MRI,most of the lesions enhanced strongly and nearly homogeneously other than areas hemorrhage or necrosis on arterial phase,but the contrast enhancement quickly disappeared on portal venous phase and delayed phase.The outcome was satisfactory with surgical resection.Conclusions HCA has nonspecific clinical manifestation.Dynamic CT and MRI images are of great value in diagnosis.Surgical resection is the optimal treatment for tumors suspected of HCA,because of the risk of intraperitoneal,intrahepatic hemorrhage and/or the malignant transformation to HCC.