LIVER-TRANSPLANTATION FOR VOLUMINOUS HEPATOCELLULAR ADENOMA IN A PATIENT WITH IDIOPATHIC PORTAL-HYPERTENSION PREVIOUSLY TREATED BY A PORTACAVAL-SHUNT

被引：5

作者：

BERNARD, PH ^{[1
]}

CARLES, J ^{[1
]}

DUMAS, F ^{[1
]}

LEBAIL, B ^{[1
]}

GARCIABARCINA, M ^{[1
]}

SARIC, J ^{[1
]}

BALABAUD, C ^{[1
]}

BIOULACSAGE, P ^{[1
]}

机构：

[1] UNIV BORDEAUX 2,PATHOL LAB,146 RUE LEO SAIGNAT,F-33076 BORDEAUX,FRANCE

来源：

EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY | 1994年 / 6卷 / 03期

关键词：

IDIOPATHIC PORTAL HYPERTENSION; HEPATOCELLULAR ADENOMA; PORTACAVAL SHUNT;

D O I：

10.1097/00042737-199403000-00014

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Patient: A patient, born in 1955, presented with episodes of documented variceal bleeding in 1978 due to portal hypertension. Liver function tests were normal. An end-to-side portacaval shunt was performed in 1 980. The liver was reported to be macroscopically subnormal. A liver biopsy was interpreted as 'incomplete cirrhosis' without inflammation. Results: Six years later, the patient developed a voluminous tumour (9.5 cm in diameter) occupying the entire right liver lobe. Surgical removal of the tumour was necessary since it was a large hepatocellular adenoma with a possibility of fatal uncontrollable haemorrhage and eventual malignant transformation. In the non-tumoral liver, the parenchyma showed varying abnormalities with the characteristic features of idiopathic portal hypertension. The atrophied state of the liver and low indocyanine green clearance, combined with the fact that it was impossible to partially restore portal blood flow to increase the liver mass, ruled out a right hepatectomy. An orthotopic liver transplant, therefore, was performed. This patient has never been exposed to either oestrogens or androgens. Conclusions: This case could be another example of hepatocellular adenoma secondary to an increase in the production of oestrogens by non-ovarian sources as a result of portacaval shunt.

引用

页码：269 / 274

页数：6

共 28 条

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