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Hepatic sclerosing hemangioma (HSH) is a rare benign tumor that is considered fibrosis and hyaline change caused by degenerative changes of cavernous angioma, and changes in pathological features cause the changes in imaging features, making this atypical hemangioma easily misdiagnosed as primary or metastatic malignant tumor. Although there are many studies on the imaging findings of this disease, it is still difficult to diagnose and most patients underwent resection since it is misdiagnosed as malignant tumor. There is still a low rate of confirmed diagnosis before surgery. This article elaborates on the etiology, clinical manifestations and pathological features, imaging findings, diagnosis, and treatment of HSH, in order to provide a reference for the diagnosis and treatment of this disease.
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Objective:To compare ultrasound (US) guided versus computed tomography (CT) guided radiofrequency ablation (RFA) in treatment of early hepatocellular carcinoma (HCC).Methods:The data of 133 patients with early HCC treated by RFA in the Department of Hepatobiliary Surgery of Shandong Provincial Hospital from February 1, 2015, to January 31, 2017, was analyzed retrospectively. These patients were divided into two groups: the US-guided group and the CT-guided group. The clinical data was collected and the factors affecting prognosis were analyzed.Results:Compared with the CT-guided group, the operation time of the US-guided group was significantly shorter [(29.0±12.0)min vs. (55.0±19.0)min, P<0.05], but the number of ablation sessions per tumor was significantly less [(1.1±0.3) vs. (2.0±0.6), P<0.05]. There was no significant difference in the complete ablation rates, postoperative complication rates and postoperative length of hospital stay between the two groups ( P>0.05). The CT-guided group was superior to the US-guided group in the local tumor recurrence and progression-free survival rates ( P<0.05). On multivariate analysis, CT-guided RFA was an independent protective factor for local tumor recurrence ( HR=0.266, 95% CI: 0.073-0.967, P<0.05) and progression-free survival ( HR=0.415. 95% CI: 0.213-0.806, P<0.05), while AFP >20 ng/ml ( HR=4.821, 95% CI: 1.714-13.560, P<0.05) was an independent risk factor for progression-free survival. Conclusion:CT-guided percutaneous RFA was superior to US-guided RFA in local treatment of early HCC, probably related to more needle placements and longer ablation time under CT guidance.
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Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide, with high morbidity and mortality and poor prognosis. The main reason for poor prognosis are difficulties in early diagnosis, common recurrence and metastasis after surgery. Therefore, early diagnosis and postoperative monitoring of HCC are particularly important to improve the overall prognosis of HCC patients. Circulating tumor cells (CTCs) are malignant tumor cells in blood circulation, which play an important role in tumor inva-sion and metastasis. As a"liquid biopsy"technique, CTC test can be performed in real-time and allows repeated monitoring of tumor cells in peripheral blood, which has great clinical application value in early tumor diagnosis, postoperative dynamic monitoring, and prognosis evaluation. In this article, the research progress of CTCs at home and abroad was retrospectively illustrated, and their detec-tion methods, research, and clinical applications for diagnosis, prognosis, and other aspects of HCC patients were systematically re-viewed.
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Objective To investigate the clinical characters of pancreatitis in patients with primary hyperparathyroidism (PHPT).Methods The clinical data of patients with PHPT undergoing parathyroidectomy from Jan.2009 to May.2014 in Peking Union Medical College Hospital were retrospectively analyzed for coexistent pancreatitis.Results 571 patients received parathyroidectomy due to PHPT during this period.Thirteen patients (2.3％)with PHPT were confirmed with coexistent pancreatitis by clinical manifestation and abdominal imaging evaluation,including acute pancreatitis in 9 patients and chronic pancreatitis in 4 patients.PHPT with pancreatitis was associated with preoperative serum intact parathyroid hormone(iPTH)higher than 500 pg/ml (P=0.025)and occurrence of hypercalcemic crisis (P=0.013).The age and sex of patients,preoperative serum calcium,gallstones,urinary calculi and bone fracture were not related with pancreatitis in this group.The average follow-up period for these patients was 34(ranging from 13 to 68)months.All patients were free from hyperparathyroidism recurrence.Only one young lady with chronic pancreatitis suffered from repeated pancreatitis after surgery.Conclusions Serum iPTH higher than 500 pg/ml and occurrence of hypercalcemic crisis were possible risk factor of pancreatitis in patients with PHPT.Parathyroidectomy can help to prevent the recurrence of pancreatitis in these patients.
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Objective To investigate the strategy of diagnosis and treatment for non-functional parathyroid cysts.Methods The clinical data of non-functional parathyroid cysts patients undergoing resection between Jan.1991 and Jan.2013 in Peking Union Medical College Hospital were retrospectively analyzed.Results Non-functional parathyroid cysts were confirmed by intra-operation exploration and post-operation pathology in 22 patients.Ultrasound scan revealed cervical cystic lesions in all patients before operations,and concomitant lesions in thyroid were found in 10 patients.The serum calcium and phosphate level were in normal range in all patients.Local excisions were performed in 11 cases for isolated cyst.Subtotal thyroidectomy were performed in 10 cases for concomitant nodular goiter or close anatomy association cyst and thyroid.Radical resection of thyroid and cervical lymph node dissection were performed in one patient for concomitant thyroid carcinoma.No operation related complications was recorded in these series.No relapse presented in these patients after more than 7 months of follow-up.Conclusion Non-functional parathyroid cysts should be considered in the differential diagnosis of cervical mass even though it rarely occurs.Surgical resection was one promising treatment for non-functional parathyroid cysts.