Kleespies A, Settmacher U, Neuhaus P
Klinik für Allgemein, Viszeral und Transplantationschirurgie, Charité, Campus Virchow Klinikum, Humboldt Universität zu Berlin, Germany.
Zentralbl Chir. 2002 Apr;127(4):326-8. doi: 10.1055/s-2002-31555.
Benign hepatic mass lesions are rare. Haemangioma, focal nodular hyperplasia and hepatocellular adenoma represent the most common ones. For the reason of serious clinical complications and potential malignant transformation of hepatic adenoma, surgical resection is the therapy of choice. Unlike adenoma focal nodular hyperplasia is mostly asymptomatic and rarely causes severe complications. We report on a spontaneous rupture and life-threatening intraperitoneal haemorrhage of a large, asymptomatic FNH, where surgical resection was indicated. Within three month after hepatic resection and after termination of oral contraceptives almost complete regeneration of liver tissue and dramatic regression of a second FNH lesion was apparent. Although haemorrhage of hepatic FNH is extremely rare, this case highlights the small risk of rupture in large lesions.
良性肝脏肿块病变较为罕见。血管瘤、局灶性结节性增生和肝细胞腺瘤是最常见的几种。由于肝细胞腺瘤存在严重的临床并发症及潜在恶变风险,手术切除是首选治疗方法。与腺瘤不同,局灶性结节性增生大多无症状,很少引起严重并发症。我们报告一例大型无症状局灶性结节性增生发生自发性破裂并导致危及生命的腹腔内出血,这种情况需行手术切除。肝切除术后三个月内,在停用口服避孕药后,肝脏组织几乎完全再生,另一个局灶性结节性增生病变显著消退。尽管肝脏局灶性结节性增生出血极为罕见,但该病例凸显了大型病变存在的小破裂风险。