探讨肺硬化性血管瘤（PSH）肝转移的临床特点、诊治和预后。

回顾性分析2012年7月郑州大学附属肿瘤医院收治的1例PSH患者临床资料。患者已签署知情同意书，符合医学伦理学规定。患者女，33岁，因体检发现右肺占位1周入院。CT示右肺中叶内侧段有一肿块，大小约4.3 cm×2.8 cm，增强扫描后肿块呈不均匀强化。CT引导下肺穿刺活检示低分化腺癌。临床诊断为肺腺癌。

患者于2012年7月9日在气管插管全身麻醉下行胸腔镜辅助下右肺中叶切除术+纵膈淋巴结清扫，术中见肿瘤位于右肺中叶，大小约4.5 cm×4.0 cm×2.2 cm。术后病理学检查诊断为低分化腺癌，部分具有PSH特征。2015年12月复查MRI示肝右叶占位。肝脏活检示PSH肝转移；HE染色示病变呈出血区、实性区、硬化区混合；免疫组化检测示甲状腺转录因子（TTF）-1阳性，上皮膜抗原（EMA）阳性。遂行超声引导下射频消融术，术后恢复良好。术后定期随访，截止至投稿日期患者病情稳定。

PSH肝转移是一种极为罕见的疾病，确诊依赖病理学检查。手术切除肿瘤是可靠的治疗手段，预后较好。

To investigate the clinical characteristics, diagnosis, treatment and prognosis of pulmonary sclerosing hemangioma (PSH) with liver metastasis.

Clinical data of one patient with PSH who was diagnosed and treated in Cancer Hospital Affiliated to Zhengzhou University in July 2012 were retrospectively analyzed. The informed consent of the patient was obtained and the local ethical committee approval was received. The female patient, aged 33 years old, was admitted to hospital due to a space-occupying mass in the right lung found by physical examination for 1 week. CT scan revealed a mass approximately 4.3 cm × 2.8 cm in size in the medial segment of the middle lobe of right lung. Enhanced CT scan revealed uneven enhancement within the mass. Low-differentiated adenocarcinoma was identified by CT-guided lung biopsy. The patient was clinically diagnosed with lung adenocarcinoma.

The patient underwent thoracoscopic resection of middle lobe of right lung + mediastinal lymph node dissection under the general anesthesia with endotracheal intubation on July 9^th, 2012. A tumor approximately 4.5 cm×4.0 cm×2.2 cm in size was found in the middle lobe of right lung during the operation. It was diagnosed as low-differentiated adenocarcinoma, part of which was characterized as PSH by postoperative pathological examination. In December 2015, a space-occupying lesion in the right lobe of liver was found by MRI re-examination. Liver biopsy indicated a PSH with liver metastasis. HE staining revealed the lesion presented a mixed type of hemorrhage, solid and cirrhosis regions. Immunohistochemical staing revealed positive outcomes for thyroid transcription factor (TTF-1) and epithelial membrane antigen (EMA). Then the patient underwent ultrasound-guided radiofrequency ablation and recovered well after surgery. The patient was followed up on a regular basis and remained physically stable until the submission date.

PSH with liver metastasis is an extremely rare disease. Clinical diagnosis relies on the results of pathological examination. Surgical resection is a reliable therapy with a relatively good prognosis.