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婴儿肝血管瘤的病史:从影像学检查到鉴别诊断

History of the infantile hepatic hemangioma: From imaging to generating a differential diagnosis.

作者信息

Gnarra Maria, Behr Gerald, Kitajewski Alison, Wu June K, Anupindi Sudha A, Shawber Carrie J, Zavras Nick, Schizas Dimitrios, Salakos Chris, Economopoulos Konstantinos P

机构信息

Maria Gnarra, Vascular Biology Program, Department of Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA 02115, United States.

出版信息

World J Clin Pediatr. 2016 Aug 8;5(3):273-80. doi: 10.5409/wjcp.v5.i3.273.

Abstract

We aim to provide an up-to-date summary of infantile hepatic hemangioma (IHH) and its misnomers and to dialectically present the differential diagnosis of these rare entities of the liver. Eligible peer-reviewed articles on hepatic infantile hemangiomas, published between 2000 and 2015, were reviewed for this study. IHH is the most common hepatic vascular tumor in children. Once a liver mass is identified in an infant, the differential diagnosis ranges from vascular malformations to benign and malignant tumors including mesenchymal hamartoma, hepatoblastoma, metastatic neuroblastoma, so careful physical examination, imaging studies, and, if indicated, tumor markers and biopsy, are of pivotal importance to ascertain the correct diagnosis. Despite the benign nature of IHHs, some of these lesions may demand medical and/or surgical intervention, especially for multiple and diffuse IHH. Complications can include hepatomegaly, hypothyroidism and cardiac failure. Therefore, a close follow-up is required until complete involution of the lesions. We propose an algorithm to guide the physicians towards the proper management of hepatic lesions.

摘要

我们旨在提供一份关于婴儿肝血管瘤(IHH)及其误称的最新综述,并辩证地介绍这些罕见肝脏病变的鉴别诊断。本研究回顾了2000年至2015年间发表的关于肝婴儿血管瘤的符合条件的同行评审文章。IHH是儿童最常见的肝脏血管肿瘤。一旦在婴儿中发现肝脏肿块,鉴别诊断范围从血管畸形到良性和恶性肿瘤,包括间叶性错构瘤、肝母细胞瘤、转移性神经母细胞瘤,因此仔细的体格检查、影像学检查,以及必要时的肿瘤标志物检查和活检,对于确定正确诊断至关重要。尽管IHH本质上是良性的,但其中一些病变可能需要药物和/或手术干预,特别是对于多发和弥漫性IHH。并发症可能包括肝肿大、甲状腺功能减退和心力衰竭。因此,需要密切随访直至病变完全消退。我们提出一种算法,以指导医生对肝脏病变进行适当管理。

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