内容紹介
Summary
Case: A 77-year-old woman was referred to our hospital for detailed examination of a cystic liver tumor. Contrast-enhanced CT and MRI showed a cystic liver tumor with an enhanced mural nodule in S6 of the liver. Under a preoperative diagnosis of hemorrhagic hepatic cyst and mucinous cystic neoplasm(MCN)of the liver, extended posterior segmentectomy was performed. Histological examination of the tumor revealed no neoplastic cells, and the tumor was finally diagnosed as a hemorrhagic hepatic cyst of the liver. Conclusion: Similar to previous reports of hemorrhagic hepatic cysts, preoperative differential diagnosis from MCN of the liver was difficult in this case. Hemorrhagic hepatic cysts are rare and are sometimes confused with MCN of the liver, especially when an enhanced mural nodule is found in the cyst. The possibility of hemorrhagic hepatic cysts should be considered during diagnosis of liver cystic tumors.
要旨
症例は77歳,女性。前医にて肝嚢胞性腫瘤を指摘され,精査加療目的に当院紹介受診した。造影CTおよびMRIでは肝S6に径43 mm大の嚢胞性腫瘤を認め,その内部に一部造影効果を伴う壁在結節を認めた。肝粘液性嚢胞腫瘍(MCN)の可能性を考え,肝拡大後区域切除術を施行した。術後病理組織学的検査で出血性肝嚢胞と診断された。これまでの報告では,画像検査所見からは出血性肝嚢胞と肝MCNとの鑑別は困難とされ,外科的切除を施行される例が多い。肝MCNの鑑別診断の際には,まれな疾患ではあるが出血性肝嚢胞の可能性を念頭に置く必要があると考えられた。
目次
Case: A 77-year-old woman was referred to our hospital for detailed examination of a cystic liver tumor. Contrast-enhanced CT and MRI showed a cystic liver tumor with an enhanced mural nodule in S6 of the liver. Under a preoperative diagnosis of hemorrhagic hepatic cyst and mucinous cystic neoplasm(MCN)of the liver, extended posterior segmentectomy was performed. Histological examination of the tumor revealed no neoplastic cells, and the tumor was finally diagnosed as a hemorrhagic hepatic cyst of the liver. Conclusion: Similar to previous reports of hemorrhagic hepatic cysts, preoperative differential diagnosis from MCN of the liver was difficult in this case. Hemorrhagic hepatic cysts are rare and are sometimes confused with MCN of the liver, especially when an enhanced mural nodule is found in the cyst. The possibility of hemorrhagic hepatic cysts should be considered during diagnosis of liver cystic tumors.
要旨
症例は77歳,女性。前医にて肝嚢胞性腫瘤を指摘され,精査加療目的に当院紹介受診した。造影CTおよびMRIでは肝S6に径43 mm大の嚢胞性腫瘤を認め,その内部に一部造影効果を伴う壁在結節を認めた。肝粘液性嚢胞腫瘍(MCN)の可能性を考え,肝拡大後区域切除術を施行した。術後病理組織学的検査で出血性肝嚢胞と診断された。これまでの報告では,画像検査所見からは出血性肝嚢胞と肝MCNとの鑑別は困難とされ,外科的切除を施行される例が多い。肝MCNの鑑別診断の際には,まれな疾患ではあるが出血性肝嚢胞の可能性を念頭に置く必要があると考えられた。