肝血管肉瘤伴Kasabach-Merritt综合征1例报告

李梦楠; 王功臣; 张志明

doi:10.3969/j.issn.1001-5256.2021.11.032

肝血管肉瘤伴Kasabach-Merritt综合征1例报告

DOI: 10.3969/j.issn.1001-5256.2021.11.032

甘肃中医药大学附属医院肿瘤内科，甘肃省中西医结合肿瘤临床医学研究中心，兰州 730000

基金项目:

甘肃省科技计划资助 (18JR2FA001)

详细信息

通信作者:
张志明，zhangzhimingys@163.com

中图分类号: R735.7
计量
- 文章访问数: 406
- HTML全文浏览量: 84
- PDF下载量: 28
- 被引次数: 0
出版历程
- 收稿日期: 2021-04-12
- 录用日期: 2021-06-16
- 出版日期: 2021-11-20

A case of hepatic angiosarcoma with Kasabach-Merritt syndrome

Department of Medical Oncology, Affiliated Hospital of Gansu University of Chinese Medicine & Gansu Province Cancer Clinical Research Center of Integrated Traditional Chinese and Western Medicine, Lanzhou 730000, China

Research funding:

Projects of Technology in Gansu Province (18JR2FA001)

摘要

- 血管肉瘤 /
- 肝肿瘤 /
- 卡-梅氏综合征 /
- 诊断
- Hemangiosarcoma /
- Liver Neoplasm /
- Kasabach-Merritt Syndrome /
- Diagnosis

HTML全文

图 1 上腹部增强MRI检查结果

注：a~b，肝S7段见一类圆形T₁WI序列稍短信号影，T₂WI信号升高；c，DWI；d，增强动脉期；e~f，门静脉期及延迟期。

下载: 全尺寸图片幻灯片

图 2 术后实验室指标随时间的变化趋势

下载: 全尺寸图片幻灯片

表 1 实验室异常指标

指标	术后第1天	术后第2天	术后第3天	术后第4天
PLT(×10⁹/L)	110	63	50	59
INR	1.78	1.79	1.66	1.44
PT(s)	19.7	19.7	18.6	15.9
PTA(%)	45	45	49	59
FDP(μg/mL)	19.91	12.01	16.90	19.81
D-dimer(mg/mL)	6.62	6.7	7.24	7.17
AST(U/L)	1777	719	290	119
ALT(U/L)	1351	1085	714	479
TBil(μmol/L)	35.3	22.9	26.8	20.7
DBil(μmol/L)	18.5	13.4	16.3	12.0
Alb(g/L)	33.7	30.4	34.3	32.6
注：FDP，纤维蛋白原降解产物；D-dimer，D-二聚体。

下载: 导出CSV

参考文献(20)

[1]	HOLDEN CA, SPITTLE MF, JONES EW. Angiosarcoma of the face and scalp, prognosis and treatment[J]. Cancer, 1987, 59(5): 1046-1057. DOI: 10.1002/1097-0142(19870301)59:5<1046::aid-cncr2820590533>3.0.co;2-6.
[2]	LOCKER GY, DOROSHOW JH, ZWELLING LA, et al. The clinical features of hepatic angiosarcoma: A report of four cases and a review of the English literature[J]. Medicine (Baltimore), 1979, 58(1): 48-64. DOI: 10.1097/00005792-197901000-00003.
[3]	JI Y, YANG K, PENG S, et al. Kaposiform haemangioendothelioma: Clinical features, complications and risk factors for Kasabach-Merritt phenomenon[J]. Br J Dermatol, 2018, 179(2): 457-463. DOI: 10.1111/bjd.16601.
[4]	READ WL, WILLIAMS F. Metastatic angiosarcoma with Kasabach-Merritt syndrome responsive to gemcitabine and vinorelbine after failure of liposomal doxorubicin and paclitaxel: A case report[J]. Case Rep Oncol, 2016, 9(1): 177-181. DOI: 10.1159/000444747.
[5]	SINGH G, MILLS C, ASADI K, et al. Hepatic angiosarcoma as a cause of acute liver failure[J]. BMJ Case Rep, 2018, 2018: bcr2018225896. DOI: 10.1136/bcr-2018-225896.
[6]	SÁNCHEZ RODRÍGUEZ E, PINILLA PAGNON I, RÍOS LEON R, et al. Hepatic angiosarcoma in a patient with liver cirrhosis[J]. Gastroenterol Hepatol, 2019, 42(5): 304-305. DOI: 10.1016/j.gastrohep.2018.10.011.
[7]	CHAUDHARY P, BHADANA U, SINGH RA, et al. Primary hepatic angiosarcoma[J]. Eur J Surg Oncol, 2015, 41(9): 1137-1143. DOI: 10.1016/j.ejso.2015.04.022.
[8]	ZHU XX, LI ZW, ZHENG Y. A case of primary hepatic angiosarcoma with splenic metastasis and rupturet[J]. J Clin Hepatol, 2019, 35(3): 608-610. DOI: 10.3969/j.issn.1001-5256.2019.03.032. 朱锡勋, 李志伟, 郑宇. 原发性肝血管肉瘤脾转移破裂出血1例报告[J]. 临床肝胆病杂志, 2019, 35(3): 608-610. DOI: 10.3969/j.issn.1001-5256.2019.03.032.
[9]	DROLET BA, TRENOR CC 3rd, BRANDǍO LR, et al. Consensus-derived practice standards plan for complicated Kaposiform hemangioendothelioma[J]. J Pediatr, 2013, 163(1): 285-291. DOI: 10.1016/j.jpeds.2013.03.080.
[10]	Society of Internal Medicaine, Chinese Medical Associatiol; WANG JX, ZHANG FC, et al. Expert consensus for diagnosis and treatment of thrombocytopenia in China[J]. Clin J Inern Med, 2020, 59(7): 498-510. DOI: 10.3760/cma.j.cn112138-20200424-00419. 中华医学会内科学分会, 王建祥, 张奉春, 等. 中国成人血小板减少症诊疗专家共识[J]. 中华内科杂志, 2020, 59(7): 498-510. DOI: 10.3760/cma.j.cn112138-20200424-00419.
[11]	LI J, CHEN RY, ZHANG JX, et al. The CT manifestations and differential diagnosis of hepatic angiosarcoma[J]. J Clin Radiol, 2018, 37(6): 968-971. DOI: 10.13437/j.cnki.jcr.2018.06.021. 李俊, 陈瑞莹, 张家雄, 等. 肝脏血管肉瘤的CT表现及鉴别诊断[J]. 临床放射学杂志, 2018, 37(6): 968-971. DOI: 10.13437/j.cnki.jcr.2018.06.021.
[12]	SHIMADA K, NAKAMOTO Y, ISODA H, et al. FDG PET for giant cavernous hemangioma: Important clue to differentiate from a malignant vascular tumor in the liver[J]. Clin Nucl Med, 2010, 35(12): 924-926. DOI: 10.1097/RLU.0b013e3181f9de11.
[13]	YOSHIDA Y, YOSHIZUMI T, WANG H, et al. Liver transplantation for cryptogenic liver failure caused by diffuse hepatic angiosarcoma: Case report[J]. Surg Case Rep, 2017, 3(1): 21. DOI: 10.1186/s40792-017-0296-0.
[14]	KATZ D, PALMERINI E, POLLACK SM. More than 50 subtypes of soft tissue sarcoma: Paving the path for histology-driven treatments[J]. Am Soc Clin Oncol Educ Book, 2018, 38: 925-938. DOI: 10.1200/EDBK_205423.
[15]	ZHENG YW, ZHANG XW, ZHANG JL, et al. Primary hepatic angiosarcoma and potential treatment options[J]. J Gastroenterol Hepatol, 2014, 29(5): 906-911. DOI: 10.1111/jgh.12506.
[16]	PARK YS, KIM JH, KIM KW, et al. Primary hepatic angiosarcoma: Imaging findings and palliative treatment with transcatheter arterial chemoembolization or embolization[J]. Clin Radiol, 2009, 64(8): 779-785. DOI: 10.1016/j.crad.2009.02.019.
[17]	CASTALDO ET, PINSON CW. Liver transplantation for non-hepatocellular carcinoma malignancy[J]. HPB (Oxford), 2007, 9(2): 98-103. DOI: 10.1080/13651820601156090.
[18]	LI KL, YAO W, QIN ZP, et al. Chinese expert consensus on diagnosis and treatment of Kasabach-Merritt phenomenon[J]. CJOMS, 2019, 17(2): 97-105. DOI:10.19438/j.cjoms.201 9.02.001. 李克雷, 姚伟, 秦中平, 等. Kasabach-Merritt现象诊断与治疗中国专家共识[J]. 中国口腔颌面外科杂志, 2019, 17(2): 97-105. DOI: 10.19438/j.cjoms.2019.02.001.
[19]	QIAO Y, YANG J, LIU L, et al. Successful treatment with pazopanib plus PD-1 inhibitor and RAK cells for advanced primary hepatic angiosarcoma: A case report[J]. BMC Cancer, 2018, 18(1): 212. DOI: 10.1186/s12885-018-3996-3.
[20]	PAOLUZZI L, CACAVIO A, GHESANI M, et al. Response to anti-PD1 therapy with nivolumab in metastatic sarcomas[J]. Clin Sarcoma Res, 2016, 6: 24. DOI: 10.1186/s13569-016-0064-0.