Gassel H J, Klein I, Gassel A M, Marx A, Kenn W, Scheurlen M, Timmermann W, Thiede A
Chirurgische Universitätsklinik Würzburg, Josef Schneider-Strasse 2, 97080 Würzburg.
Chirurg. 2002 Mar;73(3):279-82. doi: 10.1007/s00104-001-0388-y.
Glomus organs are arteriovenous anastomoses which control the thermoregulation of the extremities. Benign tumors of these glomus organs, termed "glomangiomas", are therefore most frequently located in the fingers and toes. Case reports of primary glomangiomas in the respiratory- and gastrointestinal tracts as well as in the genital organs have been published. On the other hand, glomus tumors of the liver have not yet been described. We report the case of a 61-year-old patient with a smooth subcapsular lesion within the liver detected by a routine ultrasound scan. Further diagnostic imaging did not match with one of the common liver tumors. The diagnosis of a glomangioma was finally made by liver biopsy and subsequent histology. A review of the literature revealed a potential transformation of glomangiomas. Since the patient reported on inappetence weight loss and the tumor showed growth tendency, the indication for surgical excision was made. Final histologic investigation revealed no signs of malignancy. The primary glomangioma of the liver is a new differential diagnosis of benign liver tumors. As there is a possibility of malignant degeneration, we propose the decision for surgical removal once there are clinical symptoms and a growth tendency of the lesion.
球旁器是控制四肢体温调节的动静脉吻合处。因此,这些球旁器的良性肿瘤,即“血管球瘤”,最常位于手指和脚趾。关于呼吸道、胃肠道以及生殖器官原发性血管球瘤的病例报告已有发表。另一方面,肝脏的球旁器肿瘤尚未见报道。我们报告一例61岁患者,经常规超声扫描发现肝脏内有一个光滑的包膜下病变。进一步的诊断性影像学检查结果与常见的肝脏肿瘤均不相符。最终通过肝脏活检及后续组织学检查确诊为血管球瘤。文献回顾显示血管球瘤存在潜在的转变。由于患者自述食欲不振、体重减轻且肿瘤有生长趋势,遂决定行手术切除。最终组织学检查未发现恶性迹象。肝脏原发性血管球瘤是良性肝脏肿瘤的一种新的鉴别诊断。鉴于存在恶性变的可能性,我们建议一旦出现临床症状且病变有生长趋势,应决定行手术切除。