Table 1 Test results and patient symptoms time
Time/site | Clinical features | Laboratory tests | Imageological examinations | Pathology | Treatment |
|---|---|---|---|---|---|
On March 2021; Zhongshan Hospital, Fudan University | Middle and upper abdominal pain | CA199: 101.0U/ml, AFP: 4.5ng/ml | CT: multiple space-occupying lesions in the liver PET-CT: multiple MTs, hilar lymph node metastasis in the liver | Pathology: poorly differentiated carcinoma of the liver | |
On April 2021 Hangzhou First People's Hospital | Intolerable abdominal pain, systemic skin yellowing with skin itching | ALT:242U/L AST: 404 U/L Total bilirubin 308.2 µmol/L Prothrombin time: 15.1 s Blood routine: WBC: 12.7 * 109/L, hemoglobin: 89 g/L, RBC: 3.48 * 1012/L Hepatitis B surface antigen negative | CT: Malignant tumors were considered, with a high possibility of hepatocellular carcinoma or cholangiocarcinoma MRI: consider malignant tumor combine with intrahepatic multiple metastases Abdominal ultrasound: multiple hypoechoic masses in liver, possibility of liver cancer | Pathology and immunohistochemistry: EBV infection-associated poorly differentiated cholangiocarcinoma | 1. Ademetionine 1000 mg Qd for choleresis treatment 2. Vitamin K1 injection 30 mg Qd for thromboprophylaxis, cefoperazone 3. Sodium and sulbactam sodium injection 2g Q8h for anti-infection 4. Transfusion of type O RH positive suspended red blood cells 5. Ultrasound-guided biliary drainage for jaundice reduction treatment |
On June 2021 Hangzhou Shulan Hospital | Abdominal pain | EBV infection-associated poorly differentiated cholangiocarcinoma. Regional lymph nodes: (groups 7, 8 and 9) 7/8 lymph node cancer metastases | 1. Liver transplantation 2. Tacrolimus for anti-rejection 3. Entecavir for antiviral therapy 4. Gemcitabine 1.2 g combined with cis-platinum 30 mg for chemotherapy | ||
On July 2021 Hangzhou First People's Hospital | Status post liver transplant, low-grade fever | Bile bacterial culture: enterococcus faecalis | Abdominal ultrasound: right pleural effusion, peritoneal effusion | Piperacillin tazobactam 4.5g Q8h Intravenous drip for anti-infection | |
On December 2021 At home | The condition deteriorated | Give up treatment The patient died |