Zusammenfassung
Wir berichten über eine 18-jährige Patientin mit einem fibrolamellären Leberzellkarzinom (FLC), welches eine ungewöhnliche Wachstumstendenz zeigt. Vom linken Leberlappen ausgehend, wächst der Tumor nach kaudal in die Bauchhöhle bis auf Nabelhöhe. Die Läsion konnte im Rahmen einer atypischen Leberteilresektion mit einem Klammernahtgerät im Gesunden abgesetzt werden. Es wird eine Übersicht der Literatur zu Prognose und Therapie des FLC gegeben und anhand des vorliegenden Falles kritisch diskutiert.
Abstract
We report on a case of fibrolamellar carcinoma of the liver (FLC) of an 18-year-old female patient, which shows an uncommon growing pattern. Originated from the left liver lobe, it grows into the abdominal cavity descending to the umbilicus. The lesion could be removed in sano by atypical liver resection with a linear stapler. We give a review about literature concerning prognosis and therapy of FLC discussing it by means of our actual case.
Schlüsselwörter
fibrolamelläres hepatozelluläres Karzinom - Prognose und Therapie
Key words
fibrolamellar hepatocellular carcinoma - prognosis and therapy
Literatur
1
Edmondsen H A.
Differential diagnosis of tumors and tumor-like lesions of the liver in infancy and childhood.
Arch Dis Child.
1956;
1
168-186
2
Craig J R, Peters R L, Edmondson H A, Omata M.
Fibrolamellar carcinoma of the liver: A tumor of adolescents and young adults with distinctive clinico-pathologic features.
Cancer.
1980;
46
372-379
3
Berman M M, Libbey N P, Foster J H.
Hepatocellular carcinoma: Polygonal cell type with fibrous stroma: An atypical variant with a favourable prognosis.
Cancer.
1980;
46
1448-1455
4
Soreide O, Czerniak A, Bradpiece H, Bloom S, Blumgart L.
Characteristics of fibrolamellar hepatocellular carcinoma. A study of nine cases and a rewiev of the literature.
AM J Surg.
1986;
151
518-523
5
Collier N A, Weinbren K, Bloom S R, Lee Y C, Hodgson H J, Blumgart L H.
Neurotensin secretion by fibrolamellar carcinoma of the liver.
Lancet.
1984;
1
538-540
6
Paradinas F J, Melia W M, Wilkinson M L. et al .
High serum vitamin B12 binding capacity as a marker of the fibrolamellar variant of hepatocellular carcinoma.
BMJ.
1982;
285
840-842
7
Kanai T, Takabayashi T, Kawano Y, Kuramochi S, Miyazawa N.
A case of postoperative recurrence of fibrolamellar hepatovellular carcinoma with increased vitamin B12 binding capacity in a young japanese female.
Japanese Journal of Clinical Oncology.
2004;
34
346-351
8
El-Serag H B, Davila J A.
Is fibrolamellar carcinoma different from hepatocellular carcinoma? A US population-based study.
Hepatology.
2004;
39
798-803
9
Kakar S, Burgart L J, Batts K P, Garcia J, Jain D, Ferrell L.
Clinicopathologic features and survival in fibrolamellar carcinoma: Comparison with conventional hepatocellular carcinoma with and without cirrhosis.
Modern Pathology.
2005;
18
1417-1423
10
Stipa F, Yoon S S, Liau K H, Fong Y, Jarnagin W R, D'Angelica M, Abou-Alfa G, Blumgart L H, DeMatteo R P.
Outcome of patients with fibrolamellar hepatocellular carcinoma.
Cancer.
2006;
106
1331-1338
11
Hemming A W, Langer B, Sheiner P, Greig P D, Taylor B R.
Aggressive surgical management of fibrolammelar carcinoma.
J Gastrointest Surg.
1997;
1
342-346
12
Stevens W R, Johnson C D, Stephens D H, Nagorney D M.
Fibrolamellar hepatocellular carcinoma: Stage at presentation and results of aggressive surgical management.
AJR.
1995;
164
1153-1158
13
Pinna A D, Iwatsuki S, Lee G R, Todo S, Madarigaga J R, Marsch J W, Casavilla A, Dvorchik I, Fung J J, Starzl E.
Treatment of fibrolamellar heparoma with subtotal hepatectomy or transplantation.
Hepatology.
1997;
26
877-833
14
Starzl T E, Iwatsuki S, Shaw Jr B W, Nalesnik M A, Fahri D C, Van Thiel D H.
Treatment of fibrolamellar hepatoma with partial or total hepatectomy and transplantation of the liver.
Surg Gynecol Obstet.
1986;
162
145-148
15
Zografos G N, Palmer S, Papastratis G, Habib N A.
Aggressive surgical management of fibrolamellar carcinoma in puberty.
Eur J Surg Oncol.
1997;
23
570-572
16
Titelbaum D S, Burke D R, Meranze S G, Saul S H.
Fibrolamellar hepatocellular carcinoma: Pitfalls in non operative diagnosis.
Radiology.
1988;
167
25-30
17
Blachar A, Federle M P, Ferris J V, Lacomis J M, Waltz J S, Armfield D R, Chu G, Almusa O, Grazioli L, Balzano E, Li W.
Radiologists' performance in the diagnosis of liver tumors with central scars by using specific CT criteria.
Radiology.
2002;
223
532-539
18
Friedman A C, Lichtenstein J E, Goodman Z. et al .
Fibrolamellar hepatocellular carcinoma.
Radiology.
1985;
157
583-587
19
Rieber A, Brambs H J, Lauchart W, Gartner V.
Diagnosis of fibrolamellar cancer.
Radiologe.
1994;
34
196-201
20
Caseiro-Alves F, Zins M, Mahfouz A E, Rahmouni A, Vilgrain V, Menu Y, Mathieu D.
Calcification in focal nodular hyperplasia: A new problem for differentiation from fibrolamellar hepatocellular carcinoma.
Radiology.
1996;
198
889-892
21
McLarney J K, Rucker P T, Bender G N, Goodman Z D, Kashitani N, Ros P R.
Fibrolammellar carcinoma of the liver: Radiologic-pathologic correlation.
Radiographics.
1999;
19
453-471
22
Ringe B, Wittekind C, Weimannn A, Tusch G, Pichelmayer R.
Results of hepatic resection and transplantation for fibrolamellar carcinoma.
Surg Gynecol Obstet.
1992;
175
299-305
23
El Gazzaz G, Wong W, El Hadary M K. et al .
Outcome of liver resection for fibrolamellar hepatocellular carcinoma.
Transpl Int.
2000;
13
406-409
24
Hiramatsu K, Okamato K, Uesaka K, Mukaiyama H, Seno T.
Surgical management for lymph node recurrence of resected fibrolamellar hepatocellular carcinoma: A case report.
Hepato-Gastroenerology.
1999;
46
1160-1163
25
Tomoaki I, Federle M, Grazioli L, Marsh W.
Fibrolamellar Hepatocellular Carcinoma: Pre- and Posttherapie Evaluation with CT and MR Imaging.
Radiology.
2000;
217
145-151
26
O'Grady G, Polson R J, Rolles K, Calne R Y, Williams R.
Liver Transplantation for malignant disease. Results in 93 consecutive patients.
Ann Surg.
1988;
207
373-379
T. Sprenger
Abteilung für Allgemein- und Viszeralchirurgie · Universitätsmedizin Göttingen
Robert-Koch-Str. 40
37075 Göttingen
Phone: 05 51 / 39 87 65
Email: tsprenger@chirurgie-goettingen.de