Ohkura Yu, Hashimoto Masaji, Lee Seigi, Sasaki Kazunari, Matsuda Masamichi, Watanabe Goro
Yu Ohkura, Masaji Hashimoto, Seigi Lee, Kazunari Sasaki, Masamichi Matsuda, Goro Watanabe, Department of Digestive Surgery, Hepato Pancreato Billiary Surgery Unit, Toranomon Hospital, Tokyo 105-8470, Japan.
World J Gastroenterol. 2014 Jul 7;20(25):8312-6. doi: 10.3748/wjg.v20.i25.8312.
Diffuse liver hemangiomatosis with giant cavernous hemangioma in adult is extremely rare. A 35 year-old woman presented to hospital with main complaint of epigastric pain and abdominal fullness. An enhanced computed tomography scan revealed a massive liver tumor in right lobe about 150 mm in size. There was contrast enhancement at the periphery of the mass consistent with a cavernous hemangioma. She underwent right hepatectomy. Histologically, it was diagnosed as a cavernous hemangioma. And also, hemangiomatous lesions were scattered around the Glisson's capsule on the back ground liver. These hemangiomatous lesions were not recognized preoperatively. Even if we couldn't diagnose hemangiomatosis around the main giant hemangioma preoperatively, we need to take enough surgical margins because the giant hemangioma has the potential to have small hemangiomatous lesions around the tumor. We reported right hepatectomy for giant cavernous hemangioma with diffuse hepatic hemangiomatosis without an extrahepatic lesion in an adult.
成人弥漫性肝血管瘤病合并巨大海绵状血管瘤极为罕见。一名35岁女性因上腹部疼痛和腹胀为主诉入院。增强计算机断层扫描显示右叶有一个巨大肝肿瘤,大小约150毫米。肿块周边有对比增强,符合海绵状血管瘤表现。她接受了右肝切除术。组织学检查诊断为海绵状血管瘤。此外,在背景肝的Glisson包膜周围散在有血管瘤样病变。这些血管瘤样病变术前未被发现。即使术前无法诊断主要巨大血管瘤周围的血管瘤病,我们也需要切除足够的手术切缘,因为巨大血管瘤周围可能存在小的血管瘤样病变。我们报道了一例成人巨大海绵状血管瘤合并弥漫性肝血管瘤病且无肝外病变行右肝切除术的病例。