Zunino Carlos, Delgado Maira, Giachetto Gustavo
Departamento de Pediatría, Facultad de Medicina, Universidad de la República, Uruguay.
Hospital de Tacuarembó, Administración de los Servicios de Salud del Estado, Uruguay.
Rev Chil Pediatr. 2019 Jun;90(3):316-320. doi: 10.32641/rchped.v90i3.856.
Hepatic hemangioendothelioma is a rare benign tumor in children, which frequently occurs in the first year of life. The clinical presentation is variable and the diagnosis is based on clinical suspicion, and laboratory and imaging studies. The objective was to describe a case of multifocal hepa tic hemangioendothelioma.
3-month-old girl who presented hepatomegaly without elements of hepatic or heart failure. Abdominal ultrasound and CT scan were used to diagnose hepatic hemangioendothelioma, which was confirmed by CT abdominal angiography. The patient received glucocorticoid treatment at high doses for a prolonged period. A year and a half after treatment, there was evidence of tumor remission. She had side effects from the established treatment.
In asymptomatic patients with isolated hepatomegaly, it should be considered a probable tumor patho logy, considering the clinic and imaging studies. Possible complications and treatments risks must always be assessed. In this case, the tumor extension and its probable complications justified the use of prolonged corticosteroid therapy at high doses despite its adverse effects.
肝血管内皮瘤是儿童罕见的良性肿瘤，常见于出生后第一年。临床表现多样，诊断基于临床怀疑、实验室检查及影像学检查。目的是描述一例多灶性肝血管内皮瘤病例。
一名3个月大的女童，出现肝肿大，但无肝或心力衰竭表现。腹部超声和CT扫描用于诊断肝血管内皮瘤，腹部CT血管造影证实了诊断。该患者长期接受高剂量糖皮质激素治疗。治疗一年半后，有肿瘤缓解的迹象。她出现了既定治疗的副作用。
对于无症状的孤立性肝肿大患者，结合临床和影像学检查，应考虑可能的肿瘤性病变。必须始终评估可能的并发症和治疗风险。在本病例中，尽管有不良反应，但肿瘤范围及其可能的并发症证明高剂量长期使用皮质类固醇治疗是合理的。
