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巨大海绵状肝血管瘤的联合手术治疗:病例报告

Combined surgical treatment of giant cavernous hepatic hemangioma: A case report.

作者信息

Goncharuk R A, Rakhmonov Zh A, Stegnii K V, Krekoten A A, Shulga I V, Dvoinikova E R

机构信息

Medical Center of the Far Eastern Federal University, Aiax Settlement, 10, FEFU Campus, Building 25, Vladivostok, Russian Island 690922, Russian Federation.

Medical Center of the Far Eastern Federal University, Aiax Settlement, 10, FEFU Campus, Building 25, Vladivostok, Russian Island 690922, Russian Federation.

出版信息

Int J Surg Case Rep. 2022 May;94:107012. doi: 10.1016/j.ijscr.2022.107012. Epub 2022 Apr 2.

Abstract

INTRODUCTION AND IMPORTANCE

Hepatic hemangiomas are the most common benign liver tumors, which in most cases are small in size and do not require specific treatment. Giant hepatic hemangiomas are a rare pathology. The purpose of this report is to demonstrate the case of combined treatment of giant hepatic hemangioma.

CASE PRESENTATION

A man of the Caucasian race, 37 years old, appealed to the clinic with a complaint about the presence of palpable abdominal mass. During the examination a giant cavernous hemangioma of the left lobe of the liver with a vertical size of up to 210 mm was discovered. Endovascular transarterial embolization (ETE) of tumor-feeding hepatic artery followed by radical surgery on mass removal is performed.

CLINICAL DISCUSSION

Giant hemangiomas often cause compression of nearby structures and cause symptoms such as pain, abdominal discomfort, nausea, early food saturation, etc. Cases of spontaneous rupture of cavernous hemangioma, including fatal outcome, are also described. We suggest that some patients should go through surgical treatment even if they do not have any complaint.

CONCLUSIONS

Our experience shows that endovascular embolization of the hepatic arteries can be effectively applied as a pre-surgical preparation method in order to reduce hemangioma size and blood loss volume during surgical intervention.

摘要

引言与重要性

肝血管瘤是最常见的肝脏良性肿瘤,大多数情况下体积较小,无需特殊治疗。巨大肝血管瘤是一种罕见的病理情况。本报告的目的是展示巨大肝血管瘤联合治疗的病例。

病例介绍

一名37岁的白种男性因可触及腹部肿块就诊于诊所。检查发现肝脏左叶有一个垂直大小达210毫米的巨大海绵状血管瘤。对肿瘤供血的肝动脉进行了血管内动脉栓塞术(ETE),随后进行了切除肿块的根治性手术。

临床讨论

巨大血管瘤常导致对附近结构的压迫,并引起疼痛、腹部不适、恶心、早饱等症状。也有海绵状血管瘤自发破裂的病例描述,包括致命后果。我们建议即使有些患者没有任何症状,也应接受手术治疗。

结论

我们的经验表明,肝动脉血管内栓塞术可有效地作为一种术前准备方法,以减少手术干预期间的血管瘤大小和失血量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7782/9019224/6c0f26c0a459/gr1.jpg

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