Spitzer D, Krainz R, Graf A H, Menzel C, Staudach A
Department of Obstetrics and Gynecology, Salzburg General Hospital, Austria.
J Reprod Med. 1997 Dec;42(12):809-12.
There are only a few reports on cavernous hepatic hemangiomas after hormonal substitution or during pregnancy. So far, there have been no publications on ovulation stimulation in such patients.
We report on a 31-year-old, asymptomatic, healthy woman with an incidental ultrasound finding of a cavernous macrohemangioma (diameter, 14 cm) of the liver. For treatment of primary infertility, clomiphene citrate therapy had been administered repeatedly in the past. Because these treatments were not successful and andrologic subfertility existed, homologous intrauterine insemination was recommended. The first treatment cycle with clomiphene citrate, human chorionic gonadotropin and subsequent intrauterine insemination was successful. During pregnancy, 2.5-cm growth of the liver hemangioma and a smaller, second lesion occurred but remained asymptomatic. Primary cesarean section was performed at 37 weeks' gestation to prevent rupture or hemorrhage of the hepatic hemangioma. Macrohemangiomas of the liver are associated with the risk of rupture and severe hemorrhage due to pressure during pregnancy and delivery.
During ovulation stimulation, pregnancy and the immediately postpartum period, there was no change in this benign tumor.
关于激素替代治疗后或孕期发生肝海绵状血管瘤的报道较少。迄今为止，尚无关于此类患者促排卵治疗的相关出版物。
我们报告一名31岁无症状健康女性，偶然通过超声检查发现肝脏有一个直径14厘米的海绵状大血管瘤。既往曾多次使用枸橼酸氯米芬治疗原发性不孕症。由于这些治疗未成功且存在男性因素导致的不育，建议进行同种异体宫腔内人工授精。第一个使用枸橼酸氯米芬、人绒毛膜促性腺激素并随后进行宫腔内人工授精的治疗周期成功。孕期肝脏血管瘤生长了2.5厘米，并且出现了一个较小的继发性病变，但仍无症状。孕37周时进行了剖宫产，以防止肝血管瘤破裂或出血。孕期和分娩时，肝脏大血管瘤因受压有破裂和严重出血的风险。
在促排卵、孕期及产后即刻，该良性肿瘤无变化。
