Objective To study the clinical features, diagnosis,and treatment of hepatolithiasis complicated with cholangiocaminoma. MethodsClinical and pathological data were analysed retrospectively on 46 cases of hepatolithiasis complicated with cholangiocarcinoma. Results The results showed that the incidence of cholangiocarcinoma in hepatolithiasis was 4%, and 33% of patients were diagnosed as cholangiocarcinoma preoperatively. Tumor occurring in left intrahepatic ducts, right intrahepatic ducts, and hilar bile duct was 72%, 9% and 20%, respectively. Only 15(33%) cases underwent radical resection with 1-, 2-, and 3 year survival rate of 100%, 67% and 25% for the 12 cases that were closely followed-up. None of 15 cases receiving palliative bile duct drainage had survived for 1 year. KG2Conclusions Patients with a history of hepatolithiasis more than 10 years are under the risk of cholangiocarcinoma.During a surgery for hepatolithiasis a thorough exploration for the possible coexistance of cholangiocarcinoma is strongly recommended.

Objective To investigate the clinical characteristics, management and prognosis of gestational trophoblastic disease in women aged 50 years or more. Methods Thirty-eight cases of gestational trophoblastic disease in women aged 50 years or more, who were treated in Peking Union Medical College Hospital between 1992 and 2002, were reviewed retrospectively. Results The median age was 52 years (range from 50 to 58 years ). The lesions included 5 hydatidiform moles (13%), 19 invasive moles (50%), 12 choriocarcinomas (32%) and 2 placenta site trophoblastic tumors (5%). All of 38 cases presented with abnormal vaginal bleeding. Twenty-three cases of hydatidiform moles were diagnosed at their first visit to the hospital, and 15 of them received prophylactic chemotherapy, of whom 10 progressed to invasive mole, 3 developed lung metastasis. All of the other 8 cases without prophylactic chemotherapy progressed to malignant changes with metastasis of lung. The use of prophylactic chemotherapy reduced the incidence of subsequent metastasis. All of 38 cases received chemotherapy. Thirty-two cases underwent hysterectomy, complete remission was achieved in 91% of patients; complete remission was achieved in 2 of 6 patients without hysterectomy. Conclusions The diagnosis of pregnancy and pregnancy-related disease should be considered in the elderly women presenting with abnormal vaginal bleeding. Once gestational trophoblastic disease in women aged 50 years or more is diagnosed, chemotherapy should be given as soon as possible. Hysterectomy is frequently required to improve the prognosis of gestational trophoblastic disease in the elderly women.