今井 英夫¹, 堀口 祐爾¹, 大漉 正夫¹, 北野 徹¹, 高川 寛子¹, 中野 浩¹, 中島 澄夫¹, 伊藤 圓¹, 宮川 秀一²

Hideo IMAI¹, Yuji HORIGUCHI¹, Masao OHSUKI¹, Tohru KITANO¹, Hiroko TAKAGAWA¹, Hiroshi NAKANO¹, Sumio NAKAJIMA¹, Madoka ITOH¹, Syuichi MIYAGAWA²

¹藤田学園保健衛生大学消化器内科, ²藤田学園保健衛生大学外科

¹Department of Gastroenterology, Fujita-Gakuen Health University School of Medicine, ²Department of Surgery, Fujita-Gakuen Health University School of Medicine

キーワード : Liver, Squamous cell carcinoma, Ultrasound

We experienced a very rare case of squamous cell carcinoma of the liver. A 66-year-old man, complaining of abdominal fullness and back pain, admitted to our hospital because of suspicion of the liver tumor. Sonography, performed on admission, demonstrated dilatation of intrahepatic bile ducts and extremely hyperechoic mass without halo and posterior echo attenuation. In addition, another direction of scanning revealed that the interior of the mass was uneven and less hyperechoic. Endoscopic retrograde cholangiography (ERC) delineated stenosis of the upper bile duct (2.5 cm in length) and direct communication between the bile duct and the tumor. Angiography, on the other hand, could reveal neither tumor vessel nor stain. Cholangiocellular carcinoma invading to the upper bile duct was suspected from these findings, and the patient operated on. But the tumor could not be resected because of invasion to the inferior vena cava. The patient died 30 days after the operation due to hepatic failure, and autopsy was carried out. Pathological findings showed the tumor consisted of pure squamous cell carcinoma without elements of adenocarcinoma. Compared sonogram with macroscopic findings of the tumor, echogenicity of the mass was considered to result from coarse or microcystic structure and keratosis.