tailieunhanh - Báo cáo y học: "Giant liver hemangioma resected by trisectorectomy after efficient volume reduction by transcatheter arterial embolization: a case repor"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Giant liver hemangioma resected by trisectorectomy after efficient volume reduction by transcatheter arterial embolization: a case report. | Akamatsu et al. Journal of Medical Case Reports 2010 4 283 http content 4 1 283 jAc JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Giant liver hemangioma resected by trisectorectomy after efficient volume reduction by transcatheter arterial embolization a case report 2 11 11 Nobuhisa Akamatsu Yasuhiko Sugawara Masahiko Komagome Takashi Ishida Nobuhiro Shin Narihiro Cho Fumiaki Ozawa1 Daijo Hashimoto1 Abstract Introduction Liver hemangiomas are the most common benign liver tumors usually small in size and requiring no treatment. Giant hemangiomas complicated with consumptive coagulopathy Kasabach-Merritt syndrome or causing severe incapacitating symptoms however are generally considered an absolute indication for surgical resection. Here we present the case of a giant hemangioma which was to the best of our knowledge one of the largest ever reported. Case presentation A 38-year-old Asian man was referred to our hospital with complaints of severe abdominal distension and pancytopenia. Examinations at the first visit revealed a right liver hemangioma occupying the abdominal cavity protruding into the right diaphragm up to the right thoracic cavity and extending down to the pelvic cavity with a maximum diameter of 43 cm complicated with asymptomatic Kasabach-Merritt syndrome. Based on the tumor size and the anatomic relationship between the tumor and hepatic vena cava primary resection seemed difficult and dangerous leading us to first perform transcatheter arterial embolization to reduce the tumor volume and to ensure the safety of future resection. The tumor volume was significantly decreased by two successive transcatheter arterial embolizations and a conventional right trisectorectomy was then performed without difficulty to resect the tumor. Conclusions To date there have been several reports of aggressive surgical treatments including extra-corporeal hepatic resection and liver transplantation for huge hemangiomas like