Cabrita Sofia Vargas, Gonçalves Sónia, Rodrigues Henrique, Guerra Nuno, Moura Paulo
Obstetrics Department of University Hospital of Coimbra, Rua Miguel Torga, 3030-165, Coimbra, Portugal.
Cases J. 2009 Aug 7;2:6829. doi: 10.4076/1757-1626-2-6829.
Hepatic tumors in children account for only 1 to 5% of all pediatric tumors. Hepatic hemangioma is, however, the third most common tumor of the liver in childhood. We report a case of an antenatal diagnosis of a hepatic tumor detected on a first obstetric ultrasound, at 26(th) week of gestation. It revealed a complex, predominantly solid hepatic lesion with 3 x 3 cm and a marked, essentially peripheral, Doppler blood flow. Fetal echocardiography showed a normal heart besides a vena cava displacement by the hepatic mass. Fetal Hepatic hemangioma was suspected. Follow-up ultrasounds were unchanged. Pregnancy evolved well. At 36 weeks of gestation was spontaneously delivered a 3300 g boy whose examination revealed a visible thoracoabdominal circulation and a palpable liver. No skin lesions, namely hemangiomas or petechiae were identified. Postnatal magnetic resonance imaging confirmed the diagnosis of Hepatic hemangioma. Treatment was initiated with prednisolone followed by interferon. After 2 years, there is no active lesion.
儿童肝肿瘤仅占所有儿科肿瘤的1%至5%。然而,肝血管瘤是儿童期肝脏第三常见的肿瘤。我们报告一例在妊娠26周时首次产科超声检查发现肝肿瘤的产前诊断病例。超声显示一个复杂的、以实性为主的肝内病变,大小为3×3厘米,有明显的、主要位于周边的多普勒血流信号。胎儿超声心动图显示除肝肿块导致腔静脉移位外,心脏正常。怀疑为胎儿肝血管瘤。后续超声检查结果无变化。妊娠进展顺利。妊娠36周时自然分娩一名3300克男婴,检查发现有明显的胸腹循环且肝脏可触及。未发现皮肤病变,即血管瘤或瘀点。产后磁共振成像证实了肝血管瘤的诊断。开始用泼尼松龙治疗,随后使用干扰素。2年后,无活动性病变。