PDF(Pubmed)
Abstract：
UNASSIGNED: Hepatic hemangioma is the most common type of benign mesenchymal liver tumor and often has a good prognosis. However, giant hepatic hemangioma larger than 10 cm is an unusual event, and accompanying symptoms of internal hemorrhagic necrosis are extremely rare. There are only a few cases reported.
UNASSIGNED: Herein, we report the case of a 52-year-old man with hemorrhagic necrosis of a giant hepatic hemangioma. The patient presented to the Department of Hepatobiliary Surgery with a complaint of distending pain on the right abdomen. The patient underwent hepatic artery embolization for giant hepatic hemangioma 2 weeks before presentation. During hospitalization, abdominal computed tomography revealed a mass (15.8 × 14.2 × 14.7 cm) with high density below the right lobe of the liver. The patient subsequently underwent irregular right hepatectomy with the guidance of three-dimensional visualization technology. The surgical anatomy confirmed the diagnosis of internal hemorrhagic necrosis. There was no recurrence or complications in a 4-month follow-up. Previous cases were reviewed to characterize the clinical features of giant hepatic hemangioma with internal hemorrhage necrosis.
UNASSIGNED: Cases of giant hepatic hemangioma with internal hemorrhagic necrosis are rare and usually only exhibit fever or epigastric pain. All patients in reviewed cases finally underwent surgical resection. Under these circumstances, the healing effect of transhepatic arterial treatment is not very satisfactory. Patients are deemed poor laparoscopic surgical candidates due to limited abdominal cavity. In order to standardize the diagnosis of these rare cares, the aggregation of existing and future case data is certainly warranted. If diagnosed, consideration should be given to implementing surgical resection according to patients\' condition by three-dimensional visualized technology.
UNASSIGNED: Herein, we report the case of a 52-year-old man with hemorrhagic necrosis of a giant hepatic hemangioma. The patient presented to the Department of Hepatobiliary Surgery with a complaint of distending pain on the right abdomen. The patient underwent hepatic artery embolization for giant hepatic hemangioma 2 weeks before presentation. During hospitalization, abdominal computed tomography revealed a mass (15.8 × 14.2 × 14.7 cm) with high density below the right lobe of the liver. The patient subsequently underwent irregular right hepatectomy with the guidance of three-dimensional visualization technology. The surgical anatomy confirmed the diagnosis of internal hemorrhagic necrosis. There was no recurrence or complications in a 4-month follow-up. Previous cases were reviewed to characterize the clinical features of giant hepatic hemangioma with internal hemorrhage necrosis.
UNASSIGNED: Cases of giant hepatic hemangioma with internal hemorrhagic necrosis are rare and usually only exhibit fever or epigastric pain. All patients in reviewed cases finally underwent surgical resection. Under these circumstances, the healing effect of transhepatic arterial treatment is not very satisfactory. Patients are deemed poor laparoscopic surgical candidates due to limited abdominal cavity. In order to standardize the diagnosis of these rare cares, the aggregation of existing and future case data is certainly warranted. If diagnosed, consideration should be given to implementing surgical resection according to patients\' condition by three-dimensional visualized technology.
摘要：
■肝血管瘤是良性间叶性肝肿瘤中最常见的类型，通常预后良好。然而,巨大肝血管瘤大于10厘米是一个不寻常的事件，内部出血性坏死的症状极为罕见。只有少数病例报告。
■这里，我们报道了一例52岁的巨大肝血管瘤出血性坏死患者。患者就诊于肝胆外科，主诉右腹部疼痛。患者在就诊前2周行肝动脉栓塞治疗巨大肝血管瘤。住院期间,腹部计算机断层扫描显示肝右叶下方有一个高密度肿块（15.8×14.2×14.7cm）。患者随后在三维可视化技术的指导下接受了不规则右肝切除术。手术解剖证实了内出血坏死的诊断。在4个月的随访中没有复发或并发症。回顾了以前的病例，以描述巨大肝血管瘤伴内部出血坏死的临床特征。
■伴有内部出血性坏死的巨大肝血管瘤很少见，通常仅表现为发热或上腹痛。所有患者在回顾病例中最后均行手术切除。在这种情况下,经肝动脉治疗的愈合效果不是很理想。由于腹腔有限，患者被认为是不良的腹腔镜手术候选人。为了规范这些罕见疾病的诊断，现有和未来病例数据的汇总当然是必要的。如果被诊断，应考虑通过三维可视化技术根据患者病情实施手术切除。
■这里，我们报道了一例52岁的巨大肝血管瘤出血性坏死患者。患者就诊于肝胆外科，主诉右腹部疼痛。患者在就诊前2周行肝动脉栓塞治疗巨大肝血管瘤。住院期间,腹部计算机断层扫描显示肝右叶下方有一个高密度肿块（15.8×14.2×14.7cm）。患者随后在三维可视化技术的指导下接受了不规则右肝切除术。手术解剖证实了内出血坏死的诊断。在4个月的随访中没有复发或并发症。回顾了以前的病例，以描述巨大肝血管瘤伴内部出血坏死的临床特征。
■伴有内部出血性坏死的巨大肝血管瘤很少见，通常仅表现为发热或上腹痛。所有患者在回顾病例中最后均行手术切除。在这种情况下,经肝动脉治疗的愈合效果不是很理想。由于腹腔有限，患者被认为是不良的腹腔镜手术候选人。为了规范这些罕见疾病的诊断，现有和未来病例数据的汇总当然是必要的。如果被诊断，应考虑通过三维可视化技术根据患者病情实施手术切除。
