肝原発腺扁平上皮癌の1例

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  • A CASE OF PRIMARY ADENOSQUAMOUS CARCINOMA OF THE LIVER

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We report a case of primary adenosquamous carcinoma of the liver.<br> A 61-year-old man was seen at our hospital because of pain in the right flank. Blood tests showed a ALP value of 1, 140IU/mL, CEA of 20.6ng/mL, CA19-9 over 10, 000 U/mL, and AFP within normal limits (1.4ng/mL). Hepatitis virus markers were negative. Abdominal ultrasonography and abdominal CT scan detected a mass 90mm in diameter in the right lobe of the liver, and a diagnosis of liver'cancer was made. The right lobe of the liver was resected, and the histopathological diagnosis was primary adenosquamous carcinoma of the liver. The patient died of recurrence in the form of bone metastasis three months after the operation. The tumor in this patient, which has variously been called adenoacanth-oma, adenosquamous carcinoma, and mucoepidermoid carcinoma, has been reported in a total of 127 cases in Japan since 1982. The histogenesis of the disease has been speculated to be ectopic squamous epithelium, metaplasia of glandular epithelium into squamous epithelium, and metaplasia of adenocar-cinoma into squamous epithelium, although none of these have been established. The prognosis is poor, and the disease still poses many challenges in terms of operative procedure and multidisciplinary treatment meaning unclear.

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