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A rare case of hemangioma complicated with hepatic hemangiomatosis
Un caso raro de hemangioma complicado con hemangiomatosis hepática
María del Mar Díaz Alcázar
, Francisca Luisa Sousa Domínguez
Corresponding author
UGC Aparato Digestivo, Hospital Universitario Clínico San Cecilio, Granada, Spain
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"María del Mar Díaz Alcázar, Francisca Luisa Sousa Domínguez" "autores" => array:2 [ 0 => array:4 [ "nombre" => "María del Mar" "apellidos" => "Díaz Alcázar" "email" => array:1 [ 0 => "mmardiazalcazar@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Francisca Luisa" "apellidos" => "Sousa Domínguez" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "UGC Aparato Digestivo, Hospital Universitario Clínico San Cecilio, Granada, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Un caso raro de hemangioma complicado con hemangiomatosis hepática" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 735 "Ancho" => 900 "Tamanyo" => 93587 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Cross-section of contrast-enhanced abdominal computed tomography showing hepatomegaly occupying both hypochondriac regions with giant cavernous haemangioma in the right liver lobe.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">This was a 47-year-old man, with no previous medical history, who consulted for sudden onset of abdominal pain. Stony hepatomegaly was palpable occupying both hypochondriac regions and reaching the iliac crests, for which an abdominal ultrasound was performed, followed by a computed tomography scan (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), which showed hepatomegaly measuring 37 × 29 × 23 cm due to a space-occupying lesion in the right lobe of the liver compatible with giant cavernous haemangioma. This was confirmed by contrast magnetic resonance imaging (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>), which showed that the rest of the liver parenchyma was occupied by countless lesions, suggestive of hepatic haemangiomatosis with absence of normal liver parenchyma.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Haemangiomas are the most common type of benign liver tumour.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> They are often isolated incidentalomas, but they can also cause abdominal pain, bleeding, jaundice due to biliary compression and disseminated intravascular coagulation (Kasabach-Merritt syndrome).<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Diffuse hepatic haemangiomatosis is the replacement of the liver parenchyma by haemangiomas, and often has associated systemic involvement.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The typical profile is a neonate with an abdominal mass and congestive heart failure.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Diagnosis in adults without involvement of other organs, as in our case, is very unusual.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">In patients with symptomatic haemangiomas, surgical treatment should be considered,<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> and transplantation in patients with unresectable lesions, or multiple haemangiomas in both lobes of the liver or those affecting the hilum.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> In our case, liver transplant was decided on after histological confirmation of the lesion.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 735 "Ancho" => 900 "Tamanyo" => 93587 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Cross-section of contrast-enhanced abdominal computed tomography showing hepatomegaly occupying both hypochondriac regions with giant cavernous haemangioma in the right liver lobe.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1020 "Ancho" => 900 "Tamanyo" => 72223 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Coronal slice of contrast-enhanced MRI of the liver, T2-weighted sequence, showing hepatomegaly occupying both hypochondriac regions and reaching the iliac crest. The liver parenchyma is completely occupied by lesions compatible with haemangiomas.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Emergent orthotopic liver transplantation for hemorrhage from a giant cavernous hepatic hemangioma: case report and review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.A. Vagefi" 1 => "I. Klein" 2 => "B. Gelb" 3 => "B. Hameed" 4 => "S.L. Moff" 5 => "J.P. Simko" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11605-010-1248-1" "Revista" => array:6 [ "tituloSerie" => "J Gastrointest Surg." 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