Wang Liang, Song Dan, Wu Changhua, Li Jing, Yin Jie, Guo Lei
Department of Vascular Anomalies and Interventional Radiology, Ji'nan Children's Hospital, Jinan.
Department of Interventional Radiology, Beijing Children's Hospital of Capital Medical University, Beijing, China.
Medicine (Baltimore). 2020 Jun 12;99(24):e20728. doi: 10.1097/MD.0000000000020728.
Infantile hepatic hemangioendothelioma is a type of benign hepatic tumor that occurs in infancy. Many hepatic tumors are diagnosed when screening is done for multiple cutaneous hemangiomas. Hepatic tumors are small multifocal lesions and are mostly asymptomatic. There have been many case reports of asymptomatic infantile hepatic hemangioendothelioma, but few of these have pointed out that hepatic hemangiomas can sometimes be life-threatening due to fatal hepatomegaly complications such as pulmonary artery hypertension or even congestive heart failure. At present, there are no standard protocols for treating infantile hepatic hemangioendothelioma, though most clinicians agree that treatment is unnecessary for multiple small hepatic hemangiomas in asymptomatic patients. Little is known about treatment for cases with life-threatening complications induced by infantile hepatic hemangioendothelioma as there are so few reported cases. Here, we report a special case with hepatomegaly, pulmonary artery hypertension, and cardiac insufficiency induced by infantile hepatic hemangioendothelioma.
We present a case with hepatomegaly, pulmonary artery hypertension, and cardiac insufficiency caused by infantile hepatic hemangioendothelioma.
Infantile hepatic hemangioendothelioma was diagnosed.
The patient underwent transcatheter arterial embolization and was given propranolol.
The patient responded well to treatment with transcatheter arterial embolization and propranolol. The patient gained weight steadily, liver volume, and mass size have decreased considerably, echocardiography showed normal pulmonary artery pressure and ejection fraction, and we discovered no serious complications after 1 year of follow-up.
Transcatheter arterial embolization combined with propranolol is an effective treatment for life-threatening infantile hepatic hemangioendothelioma.
婴儿肝血管内皮瘤是一种发生于婴儿期的良性肝脏肿瘤。许多肝脏肿瘤是在对多发性皮肤血管瘤进行筛查时被诊断出来的。肝脏肿瘤为小的多灶性病变,大多无症状。虽然有许多无症状婴儿肝血管内皮瘤的病例报告,但其中很少有指出肝血管瘤有时会因诸如肺动脉高压甚至充血性心力衰竭等致命性肝肿大并发症而危及生命。目前,尚无治疗婴儿肝血管内皮瘤的标准方案,不过大多数临床医生认为,无症状患者的多发性小肝血管瘤无需治疗。由于报告的病例极少,对于婴儿肝血管内皮瘤所致危及生命并发症的病例的治疗知之甚少。在此,我们报告一例由婴儿肝血管内皮瘤引起肝肿大、肺动脉高压和心脏功能不全的特殊病例。
我们报告一例由婴儿肝血管内皮瘤引起肝肿大、肺动脉高压和心脏功能不全的病例。
诊断为婴儿肝血管内皮瘤。
患者接受了经导管动脉栓塞术并服用了普萘洛尔。
患者对经导管动脉栓塞术和普萘洛尔治疗反应良好。患者体重稳步增加,肝脏体积和肿块大小显著减小,超声心动图显示肺动脉压力和射血分数正常,随访1年后未发现严重并发症。
经导管动脉栓塞术联合普萘洛尔是治疗危及生命的婴儿肝血管内皮瘤的有效方法。