Perini Marcos Vinicius, Fink Michael Anthony, Yeo David Andrew, Carvalho Carlos Alberto, Morais Carlos Floriano, Jones Robert McLaren, Christophi Christopher
Department of Surgery, Austin Hospital, The University of Melbourne, Melbourne, Victoria 3084, Australia.
ANZ J Surg. 2013 Apr;83(4):230-3. doi: 10.1111/j.1445-2197.2012.06257.x. Epub 2012 Sep 18.
Primary liver leiomyoma (PLL) should be considered in the differential diagnosis of liver lesions. A literature review has been completed and two cases are reported. The first is a 45-year-old white woman complaining of vague abdominal pain. She was initially evaluated with abdominal ultrasonography (US) that revealed a heterogeneous liver mass measuring 18 cm in greatest diameter. The tumour demonstrated hypointensity on T1-weighted and hyperintensity on T2-weighted magnetic resonance imaging. The second case is a 45-year-old Asian male who had undergone kidney transplantation 16 years ago for IgA glomerulonephritis and who developed mild, self-limiting epigastric pain. US showed a 4.3-cm-diameter lesion that was predominantly hypoechoic and was either compressing or arising from segment 2 of the liver. Computed tomography showed a well-circumscribed 4-cm-diameter mass that appeared to be arising from segments 2/3 of the liver and was adjacent to the anterior gastric wall. He underwent an uneventful laparoscopic left lateral sectionectomy and discharged on post-operative day 3. Pathological examination of the resection specimen confirmed the lesion as a PLL in each case. Herein, we report two cases of PLL and review the literature regarding this uncommon disorder.
原发性肝平滑肌瘤(PLL)应纳入肝脏病变的鉴别诊断中。我们完成了一项文献综述并报告了两例病例。第一例是一名45岁的白人女性,主诉腹部隐痛。她最初接受腹部超声检查(US),发现一个最大直径为18 cm的肝脏不均匀肿块。该肿瘤在T1加权磁共振成像上呈低信号,在T2加权磁共振成像上呈高信号。第二例是一名45岁的亚洲男性,16年前因IgA肾小球肾炎接受了肾移植,出现轻度、自限性上腹部疼痛。超声显示一个直径4.3 cm的病变,主要为低回声,压迫或起源于肝脏第2段。计算机断层扫描显示一个边界清晰、直径4 cm的肿块,似乎起源于肝脏第2/3段,与胃前壁相邻。他接受了顺利的腹腔镜左外侧肝段切除术,并于术后第3天出院。切除标本的病理检查证实两例病变均为PLL。在此,我们报告两例PLL病例,并回顾关于这种罕见疾病的文献。