Spontaneous subacute intratumoral hemorrhage of hepatic cavernous hemangioma

Shimoji, Keigo; Shiraishi, Ryuji; Kuwatsuru, A; Maehara, Tadayuki; Matsumoto, Tomoko; Kurosaki, Yoshihisa

doi:10.1007/s00261-003-0127-6

Cited by 17 publications

(16 citation statements)

References 9 publications

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“…In the late contrast phase, contrast is uniformly enhanced in the entire tumor [16] . In addition, when intratumoral hemorrhage is present, the hemangioma appears as a mass with a highly dense interior [13] . A hemangioma larger than 4 cm is classified as a "giant hemangioma" [17] and causes abdominal discomfort or pain as the tumor size increases.…”

Section: A B C Dmentioning

confidence: 99%

“…Graham et al [12] reported a case of internal hemorrhage of hemangioma in a pregnant patient, and Shimoji et al [13] reported a case of hemangioma accompanied by subacute hemorrhage and hemorrhagic anemia in a patient who was undergoing a 5-year follow-up after being diagnosed with hemangioma. Feldman et al [11] reported a case of internal hemorrhage of hemangioma in a 39-yearold man without any indicative factors in his history.…”

Section: A B C Dmentioning

confidence: 99%

“…Although rupture and hemorrhage of hepatic hemangioma are rare complications, , they can be fatal [7] . While there have been a considerable number of reports on the natural rupture of hemangioma to date [7][8][9][10] , reports on internal hemorrhage are rare [11][12][13] . The authors report a case of hemorrhagic hepatic hemangioma diagnosed incidentally during the examination of a 54-year-old woman hospitalized for epigastric pain.…”

Section: Introductionmentioning

confidence: 99%

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Hemorrhagic hemangioma in the liver: A case report

Kim

Chung

Jang

et al. 2015

WJG

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Hemangioma is the most common type of benign tumor that arises in the liver. Although rupture and hemorrhage of hepatic hemangioma are rare complications, they can be the cause of mortality. The authors report a case of hemorrhagic hepatic hemangioma: in a 54-yearold woman who was admitted with epigastric pain. She had taken oral contraceptives several weeks prior. The results of a blood examination were normal. An abdominal computed tomography scan revealed a tumor in hepatic segment 4, and a hemorrhage inside the cystic mass was suspected. The mass was removed laparoscopically to confirm the tumor properties and control the hemorrhage. The pathologic findings of the resected mass were consistent with hepatic hemangioma with intratumoral hemorrhage. The patient was discharged 8 d after the surgery, without further complications or complaints, and the patient's condition was found to have improved during follow-up.

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Section: A B C Dmentioning

confidence: 99%

Section: A B C Dmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hemorrhagic hemangioma in the liver: A case report

Kim

Chung

Jang

et al. 2015

WJG

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“…The management of a large (i. e, >10 cm) hepatic haemangioma is controversial .However, a literature search identified only 32 published cases of spontaneous rupture in adults without a history of trauma [1,6,8,12,15,[19][20][21][22][23][24][25][26][27][28][29][30]. However, actual radiological documented before and after ruptured are not well documented.…”

Section: Spontaneous Rupture Of Livermentioning

confidence: 99%

Spontaneous Rupture of Liver Haemangioma-A Case Report & Review of Literature

Islam¹,

Naraynsingh²

2014

Surgery

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A 31yrs old female patient presented with three day history of sudden right upper quadrant pain which progressively worsened over the last 24 hours. She is a known asthmatic controlled by Nasacort inhaler and also a known case of polycystic ovary diseases using oral contraceptive pills over the last 9 years.On physical examination revealed a young female in mild painful distress. Her mucous membrane was pink and moist. She was warm to touch with a temperature of 38.4°C and her vitals were within normal limit. Abdominal examination revealed moderate tenderness in right upper quadrant with mild guarding but no rebound tenderness.An USS of abdomen revealed a normal gall bladder with no peri-cholecystic fluids or gall stones with a normal CBD. However, a 7.77 x 9.42 cm cystic mass was noted in right lobe of liver and there was no free fluid ( Figure 1). A CXR revealed right basal consolidation. Her WBC was elevated 26.2 and she was also anaemic with an Hb of 11 mg/dl. Her renal function as well as electrolytes were within normal limit, however her liver enzymes were elevated AST-600, ALT-1900, ALP-238, GGT-166 with normal serum bilirubin and amylase level.After 24 hours her pain became severe and she became tachycardic with a pulse of 130 bpm with persistently elevated temperature (38.0°C). Her blood pressure and Spo2 was normal. There was decreased air entry at right lung base. Abdominal examination revealed marked tenderness with guarding but no rebound tenderness and there was sluggish bowel sound. Patient Hb had dropped from 10 gm/dl to 8 gm/dl. An Urgent CT scan of abdomen and pelvis with intravenous contrast revealed that the cyst (haemangioma) has ruptured with free fluid (blood) in Morrison pouch and in right Para-colic gutter (Figure 2). Subsequently patient developed moderate respiratory distress and was reviewed by medicine specialist. A Spiral CT of the chest-revealed mild right pleural effusion with fluid in oblique fissure but no evidence of pulmonary embolism. An MRI of abdomen was also performed which reconfirm the ruptured hepatic haemangioma. Patient was admitted in HDU and was managed successfully and discharged home on day-12.Patient had a high ESR of 39 and her liver function test became normal. Her serum alpha fetoprotein, CEA, Ca 19-9, anti-nuclear DNA levels were within normal limit. DiscussionHemangioma is the most common benign tumour affecting the liver [1,2]. Hepatic haemangioma are mesenchymal in origin and usually are solitary. Haemangioma are composed of masses of blood vessels that are atypical or irregular in arrangement and size. Exact aetiology remains unknown [3][4][5].Several pharmacologic agents have been postulated to promote tumour growth. Steroid therapy [6], oestrogen therapy, and pregnancy [7,8] can increase the size of an already existing hemangioma. Our patient was on inhalational steroid therapy for her asthmatic condition and was also on oral contraceptive pills for her polycystic ovarian disease.Incidence rate 2% in USA & the prevalence rate at necropsy is 7.4%, usual...

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“…Most hemangiomas are small and asymptomatic, but giant hemangiomas may result in abdominal discomfort, swelling, abdominal pain, jaundice, and thrombocytopenia [2]. Several authors have reported that hepatic hemangiomas has the risk of rupture, with spontaneous intraperitoneal hemorrhage and intratumoral hemorrhage [4,16]. Although a rupture is a rare event, it has a high mortality rate (60-75%) [4].…”

Section: Introductionmentioning

confidence: 99%