Arkadopoulos Nikolaos, Stafyla Vaia, Karapanos Konstantinos, Yiallourou Anneza I, Koureas Andreas, Kondi-Pafiti Agathi, Smyrniotis Vassilios
5th Department of Surgery, Aretaieion Hospital, University of Athens School of Medicine, Athens, Greece.
Ann Vasc Surg. 2010 Aug;24(6):827.e1-3. doi: 10.1016/j.avsg.2010.02.038. Epub 2010 May 13.
Giant hepatic hemangiomas are benign tumors that measure more than 4 cm and are usually asymptomatic. Pulmonary embolism (PE) is an extremely rare manifestation of giant hepatic hemangiomas. We report a case of a 44-year-old woman who suffered of recurrent pulmonary emboli that, after thorough work up, were attributed to thrombi formation inside a giant hepatic hemangioma. A right hepatectomy under vascular exclusion was performed and the hemangioma, measuring 17 cm, was resected. Two years later the patient remains asymptomatic. The report highlights the value of investigating giant liver hemangiomas in case of PE. In such cases, the hemangioma should be resected preferably under occlusion of the venous outflow of the liver to avoid PE intraoperatively.
巨大肝血管瘤是直径超过4厘米的良性肿瘤，通常无症状。肺栓塞（PE）是巨大肝血管瘤极为罕见的一种表现形式。我们报告一例44岁女性患者，该患者反复发生肺栓塞，经过全面检查后，发现栓子形成于一个巨大肝血管瘤内部。实施了血管隔离下的右肝切除术，切除了直径达17厘米的血管瘤。两年后，患者仍无症状。该报告强调了在出现肺栓塞时对巨大肝血管瘤进行检查的价值。在这种情况下，最好在阻断肝脏静脉流出道的情况下切除血管瘤，以避免术中发生肺栓塞。
