Ferrer Puchol M D, Parra Casado C La, Cervera Araez A, Sala López R, Esteban Hernández E, Cremades Mira A, Ramiro Gandia R
Servicio de Radiología, Hospital Universitario La Ribera. Alzira, Valencia, España.
Servicio de Radiología, Hospital Universitario La Ribera. Alzira, Valencia, España.
Radiologia. 2017 Sep-Oct;59(5):414-421. doi: 10.1016/j.rx.2017.04.007. Epub 2017 May 24.
To present cases of symptomatic benign liver tumors diagnosed and treated with intra-arterial embolization before surgery.
We present the cases of 7 patients diagnosed with symptomatic benign liver tumors that required treatment: 1 focal nodular hyperplasia, 2 giant cavernous hemangiomas, 1 hepatic adenomatosis, and 3 hepatic adenomas. Once the feeding arteries were identified, tumors were embolized with polyvinyl alcohol particles (500μm-700μm) and then the feeding artery was plugged with coils if there was an arterial pedicle to ensure the total vascular exclusion of the tumor. The surgical intervention took place 4 to 7 days after embolization.
All 7 patients were women (age range, 23-74 years); presurgical intra-arterial embolization was done in 6. In 1 patient with adenomatosis, embolization was done to control intraparenchymal hepatic hemorrhage. In the 6 patients who underwent surgery, the tumor was completely excised and no intraoperative bleeding events or postoperative complications occurred.
Provided there is a consensus among the multidisciplinary team, embolization is a useful option in the perioperative management of giant and/or symptomatic benign liver tumors.
介绍术前经动脉栓塞诊断和治疗的有症状良性肝肿瘤病例。
我们呈现了7例被诊断为需要治疗的有症状良性肝肿瘤患者的病例：1例局灶性结节性增生，2例巨大海绵状血管瘤，1例肝腺瘤病，3例肝腺瘤。一旦确定供血动脉，用聚乙烯醇颗粒（500μm - 700μm）栓塞肿瘤，若存在动脉蒂，则用弹簧圈栓塞供血动脉以确保肿瘤完全血管闭塞。栓塞后4至7天进行手术干预。
所有7例患者均为女性（年龄范围23 - 74岁）；6例患者术前行动脉栓塞。1例肝腺瘤病患者行栓塞以控制肝实质内出血。6例接受手术的患者中，肿瘤均被完全切除，术中无出血事件发生，术后也无并发症。
如果多学科团队达成共识，栓塞是巨大和/或有症状良性肝肿瘤围手术期管理的一种有用选择。
