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相關文獻
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頁籤選單縮合
題名 | Hepatocellular Carcinoma with Mediastinal and Pericardial Invasion: Report of Two Cases=肝細胞癌併縱膈腔及心包膜侵襲:2病例報告 |
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作者 | 黃俊誠; 伍偉華; 姜仁惠; 陳福祥; 黃吉宏; 王苑貞; 張扶陽; 李壽東; | 書刊名 | 中華醫學雜誌 |
卷期 | 62:12 1999.12[民88.12] |
頁次 | 頁891-895 |
分類號 | 415.5362 |
關鍵詞 | 肝細胞癌; 縱膈腔; 轉移; 放射治療; Hepatocellular carcinoma; Mediastinum; Metastasis; Radiotherapy; |
語文 | 英文(English) |
中文摘要 | 肝細胞癌侵襲至縱膈腔及心包膜乃屬罕見。我們報告2位C型肝炎引起之肝細胞癌病患,在數次經導管肝動脈栓塞術後發現其縱膈腔及心包膜有腫瘤生長。這2位病患皆有胸痛、氣促及端坐呼吸等臨床症狀,他們經由電腦斷層掃描、心臟超音波及磁振造影等檢查皆確診為肝細胞癌直接侵壟縱膈腔及心包膜。這2位病患分別在3及4個星期內接受總劑量3,000及4,OOO cGy的放射治療,其後臨床症狀均有明顯改善。我們建議曾接受經導管肝動脈栓塞術後之肝細胞癌末期病患,若發現有前胸窘迫之症狀,則應儘早檢查是否發生腫瘤侵襲至縱膈腔及心包膜之罕見合併症,並給予適當的治療。 |
英文摘要 | Mediastinal invasion with pericardial involvement in hepatocellular carcinoma (HCC) is rarely described. We report two patients with hepatitis-C-related HCC, who, after several courses of transcatheter arterial chemoembolization (TACE), developed mediastinal and pericardial neoplastic growth. Both patients presented with clinical manifestations of exertional dyspnea, chest pain and orthopnea. The diagnosis of HCC with pericardial involvement, through direct invasion of the anterior mediastinum, was established by computerized tomography and magnetic resonance imaging. These patients' symptoms were relieved after they received radiotherapy with a total dosage of 3,000 and 4,000 cGy over a three-week and four-week period, respectively. We suggest that direct mediastinal invasion with pericardial involvement should be considered when evaluating patients with advanced HCC who developed precordial distress following palliative TACE. Early recognition of this unusual complication is important in the management of HCC. |
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