1.Liver transplantation for hepatic metastatic pancreatic insulinoma with a survival over five years.
Xiao-Bo CHEN ; Jie YANG ; Ming-Qing XU ; Lü-Nan YAN
Chinese Medical Journal 2012;125(15):2768-2771
Pancreatic neuroendocrine tumors (NETs) are one subgroup of gastroenteropancreatic NETs. Its main characteristics are slow growth, frequent metastasis to the liver, and limited to the liver for long periods. In patients with irresectable liver metastatic NET, liver transplantation is the only radical treatment. About 160 cases of liver transplantation for liver metastatic NET have been reported worldwide. However, there is no such report of liver transplantation for hepatic metastatic NET in China by now. We herein report a case of liver transplantation for hepatic metastatic pancreatic insulinoma with a survival of over 5 years.
Humans
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Insulinoma
;
secondary
;
therapy
;
Liver Neoplasms
;
complications
;
Liver Transplantation
;
Male
;
Middle Aged
;
Pancreatic Neoplasms
;
secondary
;
therapy
2.Expert consensus on clinical diagnosis and treatment of portal hypertension with hepatocellular carcinoma (2022).
Chinese Journal of Surgery 2022;60(4):310-320
At present, there is no uniform standard for diagnosis and treatment of portal hypertension complicated with hepatocellular carcinoma internationally. Although in recent years, with the significant advances of surgical technique and the positive progress of targeted and immunotherapy in the field of hepatocellular carcinoma, the survival of hepatocellular carcinoma patients has improved, but the risk of surgery in patients with portal hypertension complicated with hepatocellular carcinoma remains high, and surgical treatment is still controversial. Therefore, based on the existing evidence, the Chinese Society of Spleen and Portal Hypertension Surgery, Chinese Society of Surgery, Chinese Medical Association has organized relevant experts to develop the consensus on clinical diagnosis and treatment of portal hypertension with hepatocellular carcinoma (2022) after full discussion. This consensus aims to provide the latest guidance for the standardized diagnosis and treatment of portal hypertension with hepatocellular carcinoma in China. Given that most portal hypertension originates from cirrhosis, this consensus only addresses the diagnosis and treatment of cirrhosis-related portal hypertension with hepatocellular carcinoma.
Carcinoma, Hepatocellular/therapy*
;
Consensus
;
Humans
;
Hypertension, Portal/therapy*
;
Liver Cirrhosis/complications*
;
Liver Neoplasms/therapy*
3.Solitary Extrahepatic Intraabdominal Metastasis from Hepatocellular Carcinoma after Liver Transplantation.
Sae Byeol CHOI ; Hyungi KIM ; Sung Hoon KIM ; Young Nyun PARK ; Kyung Sik KIM
Yonsei Medical Journal 2011;52(1):199-203
A liver transplantation is a treatment option in selected patients with hepatocellular carcinoma (HCC). Despite the adequate selection of candidates, recurrences of HCC may still develop. Solitary extrahepatic metastasis from HCC after a liver transplantation is rare. Here we report two cases of HCC demonstrated extrahepatic recurrence to the adrenal gland and spleen, respectively, within one year after a liver transplantation. Since the treatment of solitary extrahepatic metastasis from HCC after a liver transplantation is not standardized, surgical resection was performed. In the case of HCC adrenal metastasis, innumerable intrahepatic metastases were found two months after the adrenalectomy. And 16 months after adrenalectomy, the patient expired due to tumor progression and hepatic failure. In the case of HCC splenic metastasis, postoperative radiation therapy was performed. However, two recurrent HCC nodules were found 15 months after the splenectomy and received transarterial chemoembolization (TACE). And 29 month after the splenectomy, the patient also expired as same causes of former patient.
Aged
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Carcinoma, Hepatocellular/complications/*therapy
;
Humans
;
Liver Neoplasms/complications/*therapy
;
*Liver Transplantation
;
Male
;
Middle Aged
;
Neoplasm Metastasis/*diagnosis
4.Solitary Extrahepatic Intraabdominal Metastasis from Hepatocellular Carcinoma after Liver Transplantation.
Sae Byeol CHOI ; Hyungi KIM ; Sung Hoon KIM ; Young Nyun PARK ; Kyung Sik KIM
Yonsei Medical Journal 2011;52(1):199-203
A liver transplantation is a treatment option in selected patients with hepatocellular carcinoma (HCC). Despite the adequate selection of candidates, recurrences of HCC may still develop. Solitary extrahepatic metastasis from HCC after a liver transplantation is rare. Here we report two cases of HCC demonstrated extrahepatic recurrence to the adrenal gland and spleen, respectively, within one year after a liver transplantation. Since the treatment of solitary extrahepatic metastasis from HCC after a liver transplantation is not standardized, surgical resection was performed. In the case of HCC adrenal metastasis, innumerable intrahepatic metastases were found two months after the adrenalectomy. And 16 months after adrenalectomy, the patient expired due to tumor progression and hepatic failure. In the case of HCC splenic metastasis, postoperative radiation therapy was performed. However, two recurrent HCC nodules were found 15 months after the splenectomy and received transarterial chemoembolization (TACE). And 29 month after the splenectomy, the patient also expired as same causes of former patient.
Aged
;
Carcinoma, Hepatocellular/complications/*therapy
;
Humans
;
Liver Neoplasms/complications/*therapy
;
*Liver Transplantation
;
Male
;
Middle Aged
;
Neoplasm Metastasis/*diagnosis
5.Current status and progress in gastric cancer with liver metastasis.
Chinese Medical Journal 2011;124(3):445-456
OBJECTIVEThis review discusses the current status and progress in studies on gastric cancer with liver metastasis (GCLM), involving the routes, subtypes, and prognosis of GCLM; the genes and molecules associated with metastasis; the feasibility and value of each imaging modality; and current treatment options.
DATA SOURCESThe data used in this review were mainly from Medline and PubMed published in English from 2005 to August 2010. The search terms were "gastric cancer" and "liver metastasis".
STUDY SELECTIONArticles regarding the characteristics, diagnostic modalities, and various therapeutic options of GCLM were selected.
RESULTSThe prognosis of GCLM is influenced by the clinicopathological characteristics of primary tumors, as well as the presence of liver metastases. Improved understanding of related genes and molecules will lead to the development of methods of early detection and targeted therapies. For the diagnosis of GCLM, each imaging modality has its relative benefits. There remains no consensus regarding therapeutic options.
CONCLUSIONSEarly detection and characterization of liver metastases is crucial for the prognosis of gastric cancer patients. Multidisciplinary team discussions are required to design optimal treatment strategies, which should be based on the clinicopathological characteristics of each patient.
Humans ; Liver Neoplasms ; diagnosis ; drug therapy ; secondary ; surgery ; Stomach Neoplasms ; complications ; diagnosis ; drug therapy ; surgery
6.A synchronous hepatocellular carcinoma and renal cell carcinoma treated with radio-frequency ablation.
Yoon Serk LEE ; Jeong Han KIM ; Hyeon Young YOON ; Won Hyeok CHOE ; So Young KWON ; Chang Hong LEE
Clinical and Molecular Hepatology 2014;20(3):306-309
Radio-frequency ablation (RFA) is a curative treatment for hepatocellular carcinoma (HCC). Percutaneous RFA has been shown to be beneficial for patients with small renal cell carcinoma (RCC) lacking indications for resection. We experienced the case of a 53-year-old male who had conditions that suggested HCC, RCC, and alcoholic liver cirrhosis. Abdominal contrast-enhanced computed tomography (CT) and magnetic resonance image showed liver cirrhosis with 2.8 cm ill-defined mass in segment 2 of the liver and 1.9 cm hypervascular mass in the left kidney. These findings were compatible with the double primary cancers of HCC and RCC. Transarterial chemoembolization (TACE) was performed to treat the HCC. After the TACE, a focal lipiodol uptake defect was noticed on a follow up CT images and loco-regional treatment was recommended. Therefore, we performed RFAs to treat HCC and RCC. There was no evidence of recurrence in the follow up image after 1 month.
Carcinoma, Hepatocellular/complications/*diagnosis/therapy
;
Carcinoma, Renal Cell/complications/*diagnosis/therapy
;
Catheter Ablation
;
Humans
;
Kidney Neoplasms/complications/*diagnosis/therapy
;
Liver Cirrhosis/complications/*diagnosis
;
Liver Neoplasms/complications/*diagnosis/therapy
;
Magnetic Resonance Imaging
;
Male
;
Middle Aged
;
Tomography, X-Ray Computed
8.Liver Transplantation for Hepatocellular Carcinoma.
The Korean Journal of Hepatology 2006;12(4):493-506
Since the hepatocellular carcinoma (HCC) develops in cirrhotic liver and is often multicentric, liver transplantation (LT) seems to be a rational approach for the treatment of HCC. Current selection criteria of LT for HCC are Milan criteria (single nodule < or = 5 cm , or < or = 3 nodules and
9.Recommendations of EASL clinical practice guidelines on haemochromatosis.
Shan TANG ; Su Jun ZHENG ; Zhong Ping DUAN
Chinese Journal of Hepatology 2022;30(9):934-938
Haemochromatosis is characterised by elevated transferrin saturation (TSAT) and progressive iron loading that mainly affects the liver. Early diagnosis and treatment by phlebotomy can prevent cirrhosis, hepatocellular carcinoma, diabetes, arthropathy and other complications. In patients homozygous for p.Cys282Tyr in HFE, provisional iron overload based on serum iron parameters (TSAT >45% and ferritin >200 μg/L in females and TSAT >50% and ferritin >300 μg/L in males and postmenopausal women) is sufficient to diagnose haemochromatosis. In patients with high TSAT and elevated ferritin but other HFE genotypes, diagnosis requires the presence of hepatic iron overload on MRI or liver biopsy. The stage of liver fibrosis and other end-organ damage should be carefully assessed at diagnosis because they determine disease management. Patients with advanced fibrosis should be included in a screening programme for hepatocellular carcinoma. Treatment targets for phlebotomy are ferritin <50 μg/L during the induction phase and <100 μg/L during the maintenance phase.
Male
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Humans
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Female
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Hemochromatosis/therapy*
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Hemochromatosis Protein/genetics*
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Carcinoma, Hepatocellular/complications*
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Iron Overload/genetics*
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Ferritins
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Liver Cirrhosis/complications*
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Iron
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Fibrosis
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Liver Neoplasms/complications*
;
Transferrins
10.Prevention of liver cancer: basic and clinical aspects.
Experimental & Molecular Medicine 2002;34(5):319-325
Cancer prevention is a challenging project both in the basic and clinical medicine. In particular, prevention of liver cancer is the most urgent task in countries where the incidence of hepatitis virus-related liver cancer is rising. As reviewed in this article, liver cancer is going to be the first cancer that will be actually prevented by primary and secondary interventions. Even the improvement of absolute survival of the patients can be expected by successful prevention, as already demonstrated in a few clinical trials. Thus, prevention of liver cancer is promising to provide not only cost-effectiveness by morbidity reduction but also cost-benefit by mortality improvement.
Animals
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Chemoprevention
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Hepatitis B/complications/drug therapy
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Human
;
Liver Neoplasms/etiology/*prevention & control
;
Retinoids/*therapeutic use