Shimizu M, Miura J, Itoh H, Saitoh Y
First Department of Surgery, Kobe University School of Medicine, Japan.
Am J Gastroenterol. 1990 Oct;85(10):1411-3.
We describe a case of hepatic giant cavernous hemangioma with both microangiopathic hemolytic anemia (MAHA) and consumption coagulopathy, but without thrombocytopenia, which was completely cured by surgical resection of the tumor. The patient was a 54-yr-old Japanese woman whose chief complaint was right upper abdominal discomfort. Angiography and dynamic computed tomography revealed typical findings of hepatic cavernous hemangioma. The patient also had hematological disorders. At surgery, we performed an atypical right lobectomy to preserve as much normal liver tissue as possible. The patient has been well, with no related complaints or abnormal laboratory findings, 5 yr since her operation. This case indicates that giant cavernous hemangioma of the liver should be considered in the differential diagnosis of MAHA, and if surgical treatment is adequate, hematological abnormalities may be eliminated.
我们描述了一例患有微血管病性溶血性贫血（MAHA）和消耗性凝血病但无血小板减少症的肝脏巨大海绵状血管瘤病例，该病例通过肿瘤手术切除得以完全治愈。患者为一名54岁的日本女性，主要诉求是右上腹不适。血管造影和动态计算机断层扫描显示出肝海绵状血管瘤的典型表现。患者还患有血液系统疾病。手术时，我们进行了非典型右叶切除术以尽可能保留更多正常肝组织。自手术以来5年，患者情况良好，无相关主诉或实验室检查异常。该病例表明，在MAHA的鉴别诊断中应考虑肝脏巨大海绵状血管瘤，并且如果手术治疗得当，血液学异常可能会消除。
