부산대학교 도서관

Most liver cancers are carcinomas, cancers which develop from cells descended from the outermost or innermost layers of the embryo. Liver sarcomas, which arise from embryonic mesenchyme, a far less common. In some cases, the liver sarcoma retains the undifferentiated characteristics of embryonic mesodermal cells. Such cancers, embryonal sarcomas of the liver, occur most commonly in children, but may affect adults as well. Undifferentiated liver sarcomas are often thought to have an especially poor prognosis. The authors present four cases, however, which illustrate that a favorable outcome is possible. Indeed, these few cases suggest that if surgical removal of the entire tumor is possible, the chances for survival may be good. The four patients ranged in age from seven to 29 years old. In the case a 29-year-old man, it was found at the time of surgery that the cancer had extended along the common bile duct and had invaded the duodenum. Complete resection of the tumor was not possible; this patient died 13 months after the diagnosis of the sarcoma. In contrast, complete removal of the liver sarcoma was achieved in the other three cases. In only one of those patients was chemotherapy given as an adjuvant to the surgical treatment. Radiation therapy was not given in any of the three cases. All three patients remain alive without evidence of disease at 18, 30, and 144 months after surgery. Microscopic examination of tumor specimens from these patients has provided a clue to a puzzling feature of the cancerous tissue. Undifferentiated liver sarcomas have been found to contain globules, both within cells and without, which stain strongly with the dye eosin. Observations of the present specimens indicated the presence of condensed chromatin in some of these globules. Condensed chromatin is an aggregation of the DNA and proteins which make up the chromosomes; it is an indication of so-called 'programmed cell death', the process of apoptosis. In apoptosis, the cells die not because of some outside influence but because they are executing a genetic program to do so. (Consumer Summary produced by Reliance Medical Information, Inc.)