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清迈玛哈拉吉医院的一例婴儿肝血管内皮瘤/血管瘤病例

A Case of Infantile Hepatic Hemangioendothelioma/Hemangioma at Maharaj Nakorn Chiang Mai Hospital.

作者信息

Wannasai Komson, Settakorn Jongkolnee, Visrutaratna Pannee, Sathitsamitphong Lalita, Khorana Jiraporn, Waroonkun Supanat

机构信息

Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, THA.

Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, THA.

出版信息

Cureus. 2022 May 23;14(5):e25240. doi: 10.7759/cureus.25240. eCollection 2022 May.

Abstract

Infantile hepatic hemangioendothelioma/hemangioma is the most common benign hepatic vascular tumor of infancy, comprising approximately 1% of all childhood tumors. The tumor can present during the fetal or neonatal period as a hepatic mass. Common presentations include abdominal distension and a palpable hepatic mass. Clinico-radio-pathological correlation is essential for a definite diagnosis. Frequent complications such as congestive heart failure, thrombocytopenia, anemia, and Kasabach-Merritt syndrome should be investigated. Chemotherapy has been reported as an effective treatment option. Surgical resection has an essential role for symptomatic patients with medical treatment failure or other certain conditions such as refusal to take medication. Furthermore, prenatal diagnosis is essential for better patient outcomes due to prompt treatment in the neonatal period. We report a case of a female infant at 39 weeks of gestation who was delivered from a 32-year-old mother. The infant was in utero diagnosed by ultrasonography with a hepatic mass, most likely hemangioma. The mass was resected after birth and it was diagnosed as infantile hepatic hemangioendothelioma type II. The course of the disease was excellent and the patient was cured after treatment.

摘要

婴儿肝血管内皮瘤/血管瘤是婴儿期最常见的肝脏良性血管肿瘤,约占所有儿童肿瘤的1%。该肿瘤可在胎儿期或新生儿期表现为肝脏肿块。常见表现包括腹胀和可触及的肝脏肿块。临床-放射-病理相关性对于明确诊断至关重要。应调查诸如充血性心力衰竭、血小板减少、贫血和卡萨巴赫-梅里特综合征等常见并发症。化疗已被报道为一种有效的治疗选择。对于药物治疗失败或存在其他特定情况(如拒绝服药)的有症状患者,手术切除起着至关重要的作用。此外,由于在新生儿期能及时治疗,产前诊断对于改善患者预后至关重要。我们报告一例妊娠39周的女婴,其母亲32岁。该婴儿在子宫内通过超声诊断为肝脏肿块,很可能是血管瘤。出生后肿块被切除,诊断为II型婴儿肝血管内皮瘤。疾病过程良好,患者治疗后治愈。

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