CAJ | 학술논문

目的：探讨成人肝脏少见肿瘤或肿瘤样变的诊断和治疗。方法收集2009年6月至2015年5月收治的18例肝脏少见肿瘤或肿瘤样变患者的临床资料，回顾性分析临床诊治过程。结果18例患者中，纤维瘤2例，腺瘤3例，局灶结节性增生4例，癌肉瘤2例，错构瘤2例，梭形细胞瘤1例，原发性肝恶性间质瘤1例，肝结核1例，炎性假瘤2例。8例影像学诊断出现误诊，良恶性诊断准确率为50％。1例炎性假瘤术前CA19?9为246?4 kU／L，其他病例肿瘤标志物均正常。除1例肝结核因术中见胃小弯多发肿大淋巴结和膈肌硬结未行肝脏肿块切除及1例腺瘤患者行射频消融外，其他病例均行肝脏病灶完整切除（包括局部切除、肝叶肝段切除）。结论肝脏少见肿瘤或肿瘤样变术前难以确诊，检查误诊率较高，主要依靠病理诊断，治疗以手术切除为主。
목적：탐토성인간장소견종류혹종류양변적진단화치료。방법수집2009년6월지2015년5월수치적18례간장소견종류혹종류양변환자적림상자료，회고성분석림상진치과정。결과18례환자중，섬유류2례，선류3례，국조결절성증생4례，암육류2례，착구류2례，사형세포류1례，원발성간악성간질류1례，간결핵1례，염성가류2례。8례영상학진단출현오진，량악성진단준학솔위50％。1례염성가류술전CA19?9위246?4 kU／L，기타병례종류표지물균정상。제1례간결핵인술중견위소만다발종대림파결화격기경결미행간장종괴절제급1례선류환자행사빈소융외，기타병례균행간장병조완정절제（포괄국부절제、간협간단절제）。결론간장소견종류혹종류양변술전난이학진，검사오진솔교고，주요의고병리진단，치료이수술절제위주。
Objective To investigate the diagnosis and treatment of adult rare liver tumors or tumor?like lesins. Methods The clinical data of 18 cases of rare liver tumors or tumor?like lesions were collected from June 2009 to May 2015. The clinical diagno?sis and treatment of various types of liver tumors or tumor?like lesions were analyzed retrospectively. Results In 18 cases of adult rareliver tumors or tumor?like lesions, there were 2 cases of fibrous tumor, 3 cases of adenoma,4 cases of focal nodular hyperplasia, 2 ca?ses of carcinosarcoma, 2 cases of liver hamartoma, 2 cases of inflammatory pseudotumor, 1 case of spindle cell tumor, 1 case of prima?ry malignant liver mesenchymal tumor, and 1 case of hepatic tuberculosis. Imaging misdiagnosis occurred in 8 cases, and the diagnosticaccuracy of benign and malignant lesions was 50%. CA19?9 was significantly increased(246?? 4 kU/ L)in 1 cases of inflammatory pseudotumor, and the tumor markers were normal in other cases. One adenoma case underwent radiofrequency ablation and one hepatic tuber?culosis case did not undergo tumor resection and other cases underwent liver lesions complete resection(including local resection andhepatic segmental resection). Conclusion The rare liver tumors are difficult to diagnose preoperatively, and the misdiagnosis rate ishigh. Diagnosis is mainly based on the pathological indicators. Surgery is the main therapy for rare liver tumors or tumor?like lesions.