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Lifrarmeinvörp af óþekktum uppruna

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Authors
Anna Margrét Halldórsdóttir
Bjarni A. Agnarsson
Hrafn Tulinius
Kristín Bjarnadóttir
Jón Gunnlaugur Jónasson
Issue Date
2000-10-01

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Other Titles
Liver metastases of unknown origin
Citation
Læknablaðið 2000, 86(10):661-65
Abstract
Objective: Approximately 5% of cancer patients are diagnosed with tumour of unknown origin (3-4% in Iceland). Of those 10-30% have . Liver metastases of unknown origin is thus not an uncommon problem. In the present study information about the origin and histology of liver metastases of unknown origin was compiled. Material and methods: Records of all biopsies from liver metastases performed in the years 1987-1996 were retrieved from the medical database of the Department of Pathology at the University of Iceland. The biopsies came from a group of 176 patients. Ninety-two cases, in which the origin of the primary tumour was suspected or known, were excluded from the study, leaving 84 cases where the primary was completely unknown. The database of the Icelandic Cancer Society was used to gather data about the final tissue diagnosis and the location of the primary tumour when known. Results: The Cancer Society data revealed the location of the primary tumour in 55 of the 84 cases of liver metastases of unknown origin. The most prevalent (75%) primary tumours were cancers of the pancreas (15), lung (13) and colon/rectum (12). The tissue diagnosis was adenocarcinoma in 33 of the 55 cases. In the male patients 83% of the adenocarcinoma metastases came from the colon/rectum or pancreas. The corresponding figure for the female patients was 67%, while 20% of the tumours in females originated in the gallbladder and biliary tree. Conclusions: In two thirds of the cases of liver metastases of unknown origin the primary tumour was later discovered. The most prevalent tumours were cancers in the pancreas, lung and colon/rectum. Adenocarcinoma was the tissue diagnosis in 60% of cases.
Tilgangur: Um 5% krabbameinssjúklinga greinast með æxli af óþekktum uppruna (3-4% á Íslandi). Af þeim hafa 10-30% meinvörp í lifur. Lifrarmeinvörp af óþekktum uppruna er því ekki sjaldgæft vandamál. Meinafræðingar eru oft beðnir um að skoða sýni frá lifrarmeinvörpum og koma með tillögur um staðsetningu frumæxlis. Í þessari rannsókn eru teknar saman upplýsingar um uppruna og vefjagerð lifrarmeinvarpa af óþekktum uppruna. Efniviður og aðferðir: Leitað var í skrám Rannsóknastofu Háskólans í meinafræði að öllum skráðum grófnálarsýnum frá meinvörpum í lifur frá árunum 1987-1996. Alls fundust sýni frá 176 sjúklingum. Útilokaðir voru 92 sjúklingar sem höfðu þekkt frumæxli eða vísbendingu um upprunastað. Þeir 84 sjúklingar sem eftir voru töldust hafa meinvörp af óþekktum uppruna. Könnuð var niðurstaða vefjagreiningar í gögnum Rannsóknastofunnar. Leitað var í Krabbameinsskrá Krabbameinsfélags Íslands að upplýsingum um endanlega vefjagreiningu og staðsetningu frumæxlis. Niðurstöður: Krabbameinsskrá gaf upplýsingar um staðsetningu frumæxlis hjá 55 sjúklingum af 84 sem greindust með lifrarmeinvörp af óþekktum uppruna. Algengustu frumæxlin (75%) voru krabbamein í brisi (15), lunga (13) og ristli/endaþarmi (12). Hjá 33 sjúklingum af 55 var vefjagerðin kirtlakrabbamein (adenocarcinoma). Hjá körlum voru 83% kirtlakrabbameinsmeinvarpa upprunnin í ristli eða brisi, en 67% hjá konum, þar sem 20% komu frá gallblöðru/gallvegum. Ályktanir: Í tveimur þriðju tilfella kom upprunastaður að lokum í ljós fyrir lifrarmeinvörp af óþekktum uppruna. Algengustu frumæxlin voru krabbamein í brisi, lungum og ristli/endaþarmi. Kirtlakrabbamein var vefjagreiningin í 60% tilfella.
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