Shimada M, Matsumata T, Ikeda Y, Urata K, Hayashi H, Shimizu M, Sugimachi K
Second Department of Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Cancer. 1994 Jan 15;73(2):304-7. doi: 10.1002/1097-0142(19940115)73:2<304::aid-cncr2820730212>3.0.co;2-j.
A patient with multiple hepatic hemangiomas and significant arterioportal shunting who was successfully treated by a left-hepatic lobectomy is presented herein. In hemangiomas with significant arterioportal venous shunting, it is essential to differentiate between hepatocellular carcinoma and hypervascular metastatic tumors because few typical findings of hemangioma can be recognized. Moreover, an increased hepatic arterial flow can increase the risk of spontaneous rupture as well as portal hypertension due to the increased inflow to the portal vein. Therefore, a definitive diagnosis should be made by liver biopsy when imaging alone is not sufficient to rule out malignancy. Furthermore, hepatic resection for hemangiomas with significant arterioportal venous shunting may be indicated due to the higher risk of rupture and the possibility of progressive portal hypertension.
本文介绍了一名患有多发性肝血管瘤且存在明显动门脉分流的患者，该患者通过左肝叶切除术获得成功治疗。在伴有明显动门脉静脉分流的血管瘤中，必须鉴别肝细胞癌和高血运转移瘤，因为几乎无法识别血管瘤的典型表现。此外，肝动脉血流增加会增加自发破裂的风险，以及由于门静脉血流增加导致门静脉高压的风险。因此，当仅靠影像学检查不足以排除恶性肿瘤时，应通过肝活检做出明确诊断。此外，对于伴有明显动门脉静脉分流的血管瘤，由于破裂风险较高以及可能出现进行性门静脉高压，可能需要进行肝切除术。
