Lin Feizhuan, Yang Jianhui, Zhu Xin, Wu Kangze
Department of hepatopancreatobiliary surgery, Shaoxing People's Hospital, Shaoxing city, Zhejiang province, China.
Heliyon. 2024 Sep 7;10(18):e37614. doi: 10.1016/j.heliyon.2024.e37614. eCollection 2024 Sep 30.
This case report documents an exceptionally rare hepatic glomus tumor, contributing valuable insights to the diagnosis and differential diagnosis of such tumors.
A 58-year-old male was admitted in 2023 due to unexplained elevation of bilirubin discovered during routine laboratory tests. The patient denied any symptoms, and physical examination revealed no positive findings. Laboratory tests indicated elevated bilirubin, while serum tumor markers remained within normal ranges. Contrast-enhanced computed tomography revealed an indistinctly bordered hepatic mass, displaying uneven and marked enhancement in the arterial phase and sustained enhancement in the venous phase.
The patient underwent laparoscopic partial hepatectomy, and pathological examination suggested a spindle cell tumor of mesenchymal origin. Immunohistochemistry confirmed positive staining for smooth muscle actin, leading to the final diagnosis of a hepatic glomus tumor with undetermined malignant potential. Follow-up at 6 months postoperatively showed no signs of metastasis or recurrence.
This case underscores the subtle radiological distinctions of hepatic glomus tumors, resembling hemangiomas but manifesting unique features. Additionally, the crucial role of immunohistochemistry in achieving a definitive diagnosis is emphasized in this report.
本病例报告记录了一例极为罕见的肝脏血管球瘤,为这类肿瘤的诊断和鉴别诊断提供了有价值的见解。
一名58岁男性于2023年因常规实验室检查发现胆红素不明原因升高入院。患者否认有任何症状,体格检查未发现阳性体征。实验室检查显示胆红素升高,而血清肿瘤标志物仍在正常范围内。增强计算机断层扫描显示肝脏有一个边界不清的肿块,动脉期呈不均匀明显强化,静脉期呈持续强化。
主要诊断、治疗干预及结果:患者接受了腹腔镜肝部分切除术,病理检查提示为间叶源性梭形细胞瘤。免疫组织化学证实平滑肌肌动蛋白染色阳性,最终诊断为具有不确定恶性潜能的肝脏血管球瘤。术后6个月随访未发现转移或复发迹象。
本病例强调了肝脏血管球瘤在影像学上的细微差异,其类似血管瘤但具有独特特征。此外,本报告强调了免疫组织化学在明确诊断中的关键作用。