Shankar Sadhana, Rammohan Ashwin, Kulaseharan Venugopal H, Kanagavelu Rathnavel, Reddy Mettu S, Rela Mohamed
From The Institute of Liver Disease and Transplantation, Dr. Rela Institute and Medical Centre, Bharath Institute of Higher Education and Research, Chennai, India.
Exp Clin Transplant. 2021 Oct;19(10):1106-1109. doi: 10.6002/ect.2020.0330. Epub 2021 Feb 1.
Cavernous hemangiomas are the most common benign tumors of the liver and are usually asymptomatic. On the other hand, giant hemangioma and diffuse hepatic hemangiomatosis may become symptomatic by causing compression on adjacent structures, rupture, or consumptive coagulopathy. The coexistence of these 2 entities in an adult is extremely rare, and the literature, especially on their management, is sparse. We report the case of a young woman who developed a rapidly growing recurrent giant hemangioma and diffuse hepatic hemangiomatosis with significant pressure effects, raising the suspicion of a malignant tumor. She had previously undergone a liver resection and an aborted attempt at liver transplant elsewhere. As a preoperative measure, with an aim to shrink the tumor, she underwent arterial embolization and chemotherapy. After this procedure, she underwent deceased donor liver transplant. Her postoperative period was uneventful, and she was well at her 6-month follow-up. We highlight the challenges involved and the need for a multidisciplinary approach in managing these lesions. Liver transplant is an excellent option for patients who develop life-threatening complications or poor quality of life due to these benign liver tumors.
海绵状血管瘤是肝脏最常见的良性肿瘤，通常无症状。另一方面，巨大血管瘤和弥漫性肝血管瘤病可能因压迫相邻结构、破裂或消耗性凝血病而出现症状。这两种情况在成年人中同时存在极为罕见，相关文献，尤其是关于其治疗的文献非常稀少。我们报告一例年轻女性病例，她出现了快速生长的复发性巨大血管瘤和弥漫性肝血管瘤病，并伴有明显的压迫效应，引发了对恶性肿瘤的怀疑。她此前曾接受过肝脏切除术，在其他地方进行肝脏移植的尝试也未成功。作为术前措施，为了缩小肿瘤，她接受了动脉栓塞和化疗。在此手术后，她接受了尸体供肝移植。她的术后恢复顺利，6个月随访时情况良好。我们强调了处理这些病变所涉及的挑战以及多学科方法的必要性。对于因这些良性肝脏肿瘤而出现危及生命的并发症或生活质量不佳的患者，肝移植是一个极佳的选择。
