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頁籤選單縮合
題名 | Rapid Progression of Second Primary Hepatocellular Carcinoma in a Patient with Locally Advanced Rectal Cancer=直腸癌病人併發異時性第二原發肝細胞癌 |
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作者 | 黃文冠; 陳澤卿; 謝寶秀; 陳仁熙; 廖宗琦; 林永昌; 楊再勝; Huang, Wen-kuan; Chen, Tse-ching; Hsieh, Pao-shiu; Chen, Jen-shi; Liaw, Chuang-chi; Lin, Yung-chang; Yang, Tsai-sheng; |
期刊 | 臺灣癌症醫學雜誌 |
出版日期 | 20121200 |
卷期 | 28:4 2012.12[民101.12] |
頁次 | 頁189-195 |
分類號 | 416.245 |
語文 | eng |
關鍵詞 | 大腸直腸癌; 肝細胞癌; 異時性; Colorectal cancer; Hepatocellular carcinoma; Second primary tumor; |
中文摘要 | 大腸直腸癌病人罹患第二原發性癌症的機率比一般人較高,第二原發性癌症以大腸 癌及其他腸癌較為常見,然而身體其他器官仍可能發生。我們報告一位直腸癌病人在不 同時間發生第二原發肝細胞癌。一位 33 歲女性一開始診斷局部晚期直腸癌合併直腸阻塞,在接受緊急腸道造口術後接受同步化學放射線治療及後續 6 次含 oxalipltin 的化學治 療,由於腫瘤反應良好評估後接受低前位切除術切除直腸腫瘤,術後給予三個周期 irinotecan 為主的複方化學治療,術後五個月後追蹤電腦斷層掃描發現肝臟右葉出現一個 5.5 公分的腫瘤,接受擴大右肝葉切除手術後病理組織報告顯示為原發性肝細胞癌,兩個 月後左肝葉出現腫瘤合併左下腹及多處淋巴復發,給予放射線治療及 6 次緩和性化學治 療(cisplatin 和 gemcitabine),疾病雖獲得控制然而最後仍進展併發肝功能惡化,病人於 復發七個月後死亡。 |
英文摘要 | Patients with colorectal cancer are at an increased risk of developing a second primary cancer. While colon cancer is often reported as a second primary malignancy, other extracolonic malignancies may also occur. Here, we report the case of a 33-year-old woman with advanced rectal cancer who subsequently developed metachronous hepatocellular carcinoma (HCC). She was diagnosed initially with a locally advanced rectal cancer complicated with rectal obstruction, and was treated immediately with a diverting colostomy followed by concurrent chemoradiation therapy. Subsequent chemotherapy consisted of 6 cycles of modified FOLFOX-6. Because the patient responded to chemoradiotherapy, she underwent low anterior resection followed by 3 cycles of irinotecan-based chemotherapy. Five months after surgery, computed tomography scan revealed a 5.5-cm diameter liver mass at segment 8, and an extended right lobectomy was performed. The histological findings and immunochemical staining confirmed the diagnosis of HCC. Two months later, a rapidly growing left liver mass with mesenteric metastasis was found. She received palliative radiotherapy followed by 6 cycles of chemotherapy with cisplatin and gemcitabine every 4 weeks. Liver function deteriorated progressively, and the patient died 7 months after diagnosis of recurrence. |
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