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新生儿巨大肝血管瘤:一例报告。

Neonatal giant hepatic hemangioma: A case report.

作者信息

Zhu Zhenwei, Cai Peng, Zhu Jie, Chen Jianlei, Wu Bin, Gu Zhicheng, Huang Shungen, Wang Jian

机构信息

Department of Pediatric Surgery, Children's Hospital of Soochow University, Suzhou, Jiangsu Province, China.

出版信息

Medicine (Baltimore). 2018 Oct;97(42):e12863. doi: 10.1097/MD.0000000000012863.

Abstract

RATIONALE

Hepatic hemangioma is the third most common pediatric tumor, and it is rare in the neonatal period. This case study presents a rare case of hepatic hemangioma found in a neonate.

PATIENT CONCERNS

A girl who was 18 days of age with the emergence of jaundice and an abdominal mass was admitted for physical examination in the local department.

DIAGNOSES

An ultrasound showed that the hepatic left lobe was about 9 cm × 7 cm × 7 cm in size. A CT scan indicated a giant hemangioma in the hepatic left lobe. MRI detected a lesion measuring about 92 mm × 71 mm × 68 mm.

INTERVENTIONS

The patient was treated with propranolol 3.5 mg PO bid (body weight 3.8 kg) after 1 week of admission for 4 weeks, but the mass did not appear to regress. Surgery was then performed successfully.

OUTCOMES

The patient recovered well without recurrence beyond one year.

LESSONS

Imaging strategies and prenatal diagnosis are vital for the diagnosis of infantile hepatic hemangioma. Propranolol is effective in both cutaneous and hepatic multifocal and diffuse hemangioma. Adequate treatment time is necessary to cure the disease. The role of propranolol in massive hepatic hemangioma remains uncertain and needs further investigation.

摘要

理论依据

肝血管瘤是第三常见的儿科肿瘤,在新生儿期较为罕见。本病例研究展示了一例在新生儿中发现的罕见肝血管瘤病例。

患者情况

一名18日龄出现黄疸和腹部肿块的女孩因当地科室的体格检查而入院。

诊断

超声显示肝左叶大小约为9厘米×7厘米×7厘米。CT扫描显示肝左叶有一个巨大血管瘤。MRI检测到一个大小约为92毫米×71毫米×68毫米的病变。

干预措施

患者入院1周后接受普萘洛尔3.5毫克口服,每日两次(体重3.8千克),持续4周,但肿块似乎没有缩小。随后成功进行了手术。

结果

患者恢复良好,一年多未复发。

经验教训

影像学策略和产前诊断对婴儿肝血管瘤的诊断至关重要。普萘洛尔对皮肤和肝脏的多灶性及弥漫性血管瘤均有效。治愈该疾病需要足够的治疗时间。普萘洛尔在巨大肝血管瘤中的作用仍不确定,需要进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27a4/6211861/9a5f904cc032/medi-97-e12863-g001.jpg

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