Management of Giant Hepatic Hemangioma in Atypical Localization; Report of a Case and Literature Review

• Authors: Rafał Stankiewicz , Konrad Kobryń , Waldemar Patkowski , Marek Krawczyk
• Languages of publication: EN

Abstracts

EN

Hemangiomas are the most common benign primary hepatic neoplasms, often being incidentally discovered. In most of the cases they are small and asymptomatic. It is widely accepted that clinical intervention is indicated only for symptomatic hemangiomas. We present a case of an asymptomatic giant hemangioma managed by enucleation due to its atypical localization. The hemangioma, originally located in segment 5, was now described in Computer Tomography (CT) Imaging as separating the gallbladder from the liver parenchyma. A careful evaluation of images revealed proximity to the portal vein (PV), right hepatic artery (RHA), right hepatic duct (RHD) and right branch of the portal vein (RBPV). Thus, in the case of an emergent operation, surgical maneuvers in the area of the altered hepatic anatomy and proximity to the hemangioma itself, would in fact increase the risk endangering the patient’s life. After patient’s consent, a surgical enucleation en block with the gall-bladder was performed. It is of great importance that specifically selected, asymptomatic patients diagnosed with a giant hemangioma, with the above mentioned or similar localization should be considered for surgical treatment.

Keywords

EN

giant hemangioma; liver benign neoplasm; cholecystectomy; tumor enucleation; liver surgery

• Publisher: De Gruyter Open
• Journal: Polish Journal of Surgery
• Year: 2015
• Volume: 87
• Issue: 3
• Pages: 139-142

Dates

published

1 - 3 - 2015

received

16 - 6 - 2014

online

3 - 7 - 2015

Contributors

author

Rafał Stankiewicz

• Department of General, Transplant and Liver Surgery, Medical University of Warsaw Kierownik: prof. dr hab. M. Krawczyk

author

Konrad Kobryń

• Department of General, Transplant and Liver Surgery, Medical University of Warsaw Kierownik: prof. dr hab. M. Krawczyk

author

Waldemar Patkowski

• Department of General, Transplant and Liver Surgery, Medical University of Warsaw Kierownik: prof. dr hab. M. Krawczyk

author

Marek Krawczyk

• Department of General, Transplant and Liver Surgery, Medical University of Warsaw Kierownik: prof. dr hab. M. Krawczyk

References

• 1. Choi BY, Nguyen MH : The diagnosis and management of benign hepatic tumors. J Clin Gastroenterol 2005; 39: 401‑12.
• 2. Schwartz SI , Husser WC : Cavernous hemangioma of the liver. A single institution report of 16 resections. Ann Surg 1987; 205: 456‑65.
• 3. Trotter JF, Everson GT: Benign focal lesions of the liver. Clin Liver Dis 2001; 5: 17‑42.
• 4. Adam YG , Huvos AG, Fortner JG : Giant hemangiomas of the liver. Ann Surg 1970; 172: 239‑45.
• 5. Corigliano N, Mercantini P, Amodio PM et al.: Hemoperitoneum from a spontaneous rupture of a giant hemangioma of the liver: report of a case. Surg Today 2003; 33: 459‑63.
• 6. Herman P, Costa ML , Machado MA et al.: Management of hepatic hemangiomas: a 14-year experience. J Gastrointest Surg 2005; 9: 853‑59.
• 7. Hamaloglu E, Altun H, Ozdemir A et al.: Giant liver hemangioma: therapy by enucleation or liver resection. World J Surg 2005; 29: 890‑93.
• 8. Assy N, Nasser G, Djibre A et al.: Characteristics of common solid liver lesions and recommendations for diagnostic workup. World J Gastroenterol. 2009 Jul 14; 15(26): 3217‑27.
• 9. Stanley P, Grinnell V, Stanton R et al.: Therapeutic embolization of infantile hepatic hemangioma with polyvinyl alcohol. AJR Am J Roentgenol 1983; 141: 1041‑51.
• 10. Park SY , Tak WY , Jung MK et al.: Symptomaticenlarging hepatic hemangiomas are effectively treated by percutaneous ultrasonography-guided radiofrequency ablation. J Hepatol 2011; 54: 559‑65.
• 11. Gozal D, Saad N, Bader D et al.: Diffuse neonatal haemangiomatosis: successful management with high dose corticosteroids. Eur J Pediatr 1990; 149: 321‑24.
• 12. Sarialioglu F, Erbay A, Demir S: Response of infantile hepatic hemangioma to propranolol resistant to high-dose methylprednisolone and interferon-α therapy. Pediatr Blood Cancer 2010 Dec 15; 55(7): 1433‑34
• 13. Cappellani A, Zanghì A, Di Vita M et al.: Spontaneous rupture of a giant hemangioma of the liver. Ann Ital Chir 2000 May-Jun; 71(3): 379‑83.
• 14. Kasabach HH , Merritt KK : Capillary hemangioma with extensive purpura. American Journal of Diseases in Children 1940; 59: 1063‑70
• 15. Klompmaker IJ , Sloof MJ , van der Meer J et al.: Orthotopic liver transplantation in a patient with a giant cavernous hemangioma of the liver and Kasabach-Merritt syndrome. Transplantation 1989 Jul; 48(1): 149‑51.
• 16. Vagefi PA, Klein I, Gelb B et al.: Emergent orthotopic liver transplantation for hemorrhage from a giant cavernous hepatic hemangioma: case report and review. J Gastrointest Surg 2011; 15: 209‑14.
• 17. Duxbury MS , Garden OJ : Giant haemangioma of the liver: observation or resection? Dig Surg 2010; 27: 7‑11.
• 18. Erdogan D, Busch OR , van Delden OM et al.: Management of liver hemangiomas according to size and symptoms. J Gastroenterol Hepatol 2007; 22: 1953‑58.
• 19. Yoon SS , Charny CK , Fong Y et al.: Diagnosis, management, and outcomes of 115 patients with hepatic hemangioma. J Am Coll Surg 2003; 197: 392‑402.
• 20. Ho HY , Wu TH, Yu MC et al.: Surgical management of giant hepatic hemangiomas: complications and review of the literature. Chang Gung Med J 2012 Jan-Feb; 35(1): 70‑78.

Identifiers

DOI

10.1515/pjs-2015-0034