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Pan B, Lyu SC, He Q. Case Report: Spontaneous Rupture of Hepatic Hemangioma. Front Med (Lausanne) 2022; 9:918748. [PMID: 35911400 PMCID: PMC9325994 DOI: 10.3389/fmed.2022.918748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background Hepatic hemangioma (HH) is a congenital vasal malformation that seemed like the most probable benign liver neoplasm, composed of masses of blood vessels, which are anomalous in arrangement and size. In most cases, HH is asymptomatic, and patients have an excellent prognosis. According to research, the location and size of the mass are correlated with the symptoms and complications. Reports of spontaneous rupture of HH have been less reported in the literature. In this emergency condition, dynamic contrast-enhanced CT scanning, especially triple-phase computed tomography (CT) with delayed imaging, is preferred. Case Presentation Here, we presented two middle-aged female patients with spontaneous rupture of HH in our hospital. Following an accurate diagnosis of enhanced CT and emergency surgery, patients recovered well and were discharged from the hospital. Conclusion Appropriate imaging studies, especially enhanced CT, and emergency surgery are indispensable for patients with spontaneous rupture of HH. As a surgeon, we need to pay attention to the asymptomatic patient with HH.
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2
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Yoshimizu C, Ariizumi S, Kogiso T, Sagawa T, Taniai M, Honda G, Egawa H, Tokushige K. Giant Hepatic Hemangioma Causing Prolonged Fever and Indicated for Resection. Intern Med 2022; 61:1849-1856. [PMID: 34803101 PMCID: PMC9259820 DOI: 10.2169/internalmedicine.8405-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Hepatic hemangiomas are benign liver tumors, and most of them progress asymptomatically. We report a case of hepatic hemangioma considered the cause of fever. A 53-year-old woman had a fever of 40°C for about 3 months without infection. Hepatic hemangiomas with internal bleeding of 10 cm in size on liver S8/7 and S3/2 were observed. These were resected laparoscopically for diagnostic treatment. She was afebrile after the operation. The pathological diagnosis was hematoma inside cavernous hemangioma. It should be noted that a bleeding hepatic hemangioma may cause fever of unknown origin and be indicated for resection.
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Affiliation(s)
- Chihiro Yoshimizu
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
| | - Shunichi Ariizumi
- Institute of Gastroenterology, Department of Surgery, Tokyo Women's Medical University, Japan
| | - Tomomi Kogiso
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
| | - Takaomi Sagawa
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
| | - Makiko Taniai
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
| | - Goro Honda
- Institute of Gastroenterology, Department of Surgery, Tokyo Women's Medical University, Japan
| | - Hiroto Egawa
- Institute of Gastroenterology, Department of Surgery, Tokyo Women's Medical University, Japan
| | - Katsutoshi Tokushige
- Institute of Gastroenterology, Department of Internal Medicine, Tokyo Women's Medical University, Japan
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3
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Hanai S, Kobayashi K, Ito R, Nakagomi D. Internal Hemorrhaging of Hepatic Hemangioma Presenting with a Fever. Intern Med 2022; 61:1475-1476. [PMID: 34670881 PMCID: PMC9152851 DOI: 10.2169/internalmedicine.7530-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Shunichiro Hanai
- Department of Rheumatology, University of Yamanashi Hospital, Japan
- Third Department of Internal Medicine, University of Yamanashi, Japan
| | - Kei Kobayashi
- Department of Rheumatology, University of Yamanashi Hospital, Japan
- Third Department of Internal Medicine, University of Yamanashi, Japan
| | - Ryosuke Ito
- Department of Rheumatology, University of Yamanashi Hospital, Japan
- Third Department of Internal Medicine, University of Yamanashi, Japan
| | - Daiki Nakagomi
- Department of Rheumatology, University of Yamanashi Hospital, Japan
- Third Department of Internal Medicine, University of Yamanashi, Japan
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4
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Agnello F, Rabiolo L, Midiri F, Lo Re G, Grassedonio E, La Grutta L, Buscemi S, Agrusa A, Galia M. Focal hepatic intrinsically hyperattenuating lesions at unenhanced CT: Not always calcifications. Clin Imaging 2021; 80:304-314. [PMID: 34482241 DOI: 10.1016/j.clinimag.2021.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/26/2021] [Accepted: 08/13/2021] [Indexed: 11/27/2022]
Abstract
Due to the growing use of CT, there has been an increase in the frequency of detecting focal liver lesions. Intrinsically hyperattenuating hepatic lesions or pseudolesions are not uncommon at unenhanced CT. Hyperattenuating hepatic lesions can be divided into non-calcified and calcified. Causes of intrinsic hyperattenuation include hemorrhage, thrombosis, and calcifications. Focal liver lesions can show hyperattenuation on unenhanced CT in case of severe liver steatosis. Recognition of etiologies associated with hyperattenuation on unenhanced CT can help the radiologist in characterizing focal liver lesions and pseudolesions. In this paper, we describe the spectrum of intrinsically hyperattenuating focal liver lesions and pseudolesions at unenhanced CT.
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Affiliation(s)
- Francesco Agnello
- Section of Radiological Sciences, Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Lidia Rabiolo
- Section of Radiological Sciences, Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Federico Midiri
- Section of Radiological Sciences, Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Giuseppe Lo Re
- Section of Radiological Sciences, Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Emanuele Grassedonio
- Section of Radiological Sciences, Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Ludovico La Grutta
- Section of Radiological Sciences, Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Salvatore Buscemi
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Antonino Agrusa
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Massimo Galia
- Section of Radiological Sciences, Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy.
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5
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Wang A, Chen H, Huang Z, Tang H, Shi H, Wen J, Li Q, Jiang Y, Fu W. Spontaneous internal hemorrhage of a giant hepatic hemangioma with infection: a case report and literature review. J Int Med Res 2021; 48:300060520976474. [PMID: 33284661 PMCID: PMC7724420 DOI: 10.1177/0300060520976474] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Spontaneous internal hemorrhage from a hepatic hemangioma is rare. This case
describes a 59-year-old woman who was hospitalized with recurrent cough and
fever for 6 months. The doctor thought that she had pneumonia, but other
infectious diseases could not be ruled out. Therefore, related tests were
performed and strong antibiotics were used, but the symptom of fever was
persistent and recurred. Enhanced computed tomography (CT) findings showed a
right hepatic giant hemangioma with hemorrhage, while tuberculosis, liver
abscess, and immune disease were excluded by the physician. Because the
patient’s fever was associated with a large hepatic hemangioma, the patient was
transferred to surgery. During treatment, the amount of bleeding increased, so
she underwent a right hepatic hemangioma resection in the emergency department.
Her postoperative fever symptoms subsequently resolved. Pathological examination
confirmed hemorrhagic necrosis with infection in hepatic hemangioma. Follow-up
showed that the patient was afebrile.
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Affiliation(s)
- Ankang Wang
- Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical University, Sichuan, China.,Department of General Surgery, Nanchong Central Hospital, The second Clinical College of North Sichuan Medical College, Nanchong, Sichuan, China
| | - Hao Chen
- Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical University, Sichuan, China
| | - Zhiwei Huang
- Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical University, Sichuan, China
| | - Hong Tang
- Department of Pathology, The Affiliated Hospital of Southwest Medical University, Sichuan, China
| | - Hao Shi
- Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical University, Sichuan, China
| | - Jian Wen
- Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical University, Sichuan, China
| | - Qiu Li
- Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical University, Sichuan, China
| | - Yu Jiang
- Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical University, Sichuan, China
| | - Wenguang Fu
- Department of Hepatobiliary Surgery, The Affiliated Hospital of Southwest Medical University, Sichuan, China
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6
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Yang YG, Chen WF, Mai WH, Li XF, Zhou HL, Liu LJ, Li MY. Spontaneous intracapsular hemorrhage of a giant hepatic cavernous hemangioma: a rare case report and literature review. BMC Gastroenterol 2021; 21:84. [PMID: 33622256 PMCID: PMC7903738 DOI: 10.1186/s12876-021-01666-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/12/2021] [Indexed: 11/28/2022] Open
Abstract
Background Hepatic cavernous hemangioma is the most common type of benign liver tumor. Although ruptures and hemorrhages of hepatic hemangioma are rare complications, they are associated with high mortality. Most practitioners only pay more attention to abdominal hemorrhages caused by the rupture of hepatic hemangiomas. However, spontaneous intracapsular hemorrhages can often be neglected and poorly understood. Case presentation A 65-year-old man was referred to our institution with right upper quadrant pain, which had occurred suddenly and without a history of recent trauma. The blood test results were normal. Magnetic resonance imaging (MRI) of the abdomen showed a cystic mass in the right liver lobe. Considering the possibility of hepatic cystadenoma with hemorrhage, the patient underwent a right hepatic lobectomy. The pathological findings unexpectedly revealed intratumoral hemorrhage of hepatic hemangioma. The patient recovered well and was discharged eight days after surgery. Conclusions Intracapsular hemorrhage of hepatic cavernous hemangioma is challenging to diagnose and has a high potential risk of rupture. MRI is beneficial for diagnosing subacute internal hemorrhage cases, and it is recommended to undergo surgery for patients with a definitive diagnosis.
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Affiliation(s)
- Yong-Guang Yang
- Department of Hepatobiliary Surgery, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, People's Republic of China
| | - Wei-Feng Chen
- Department of Hepatobiliary Surgery, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, People's Republic of China
| | - Wei-Heng Mai
- Department of Hepatobiliary Surgery, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, People's Republic of China
| | - Xiao-Fang Li
- Department of Pathology, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, People's Republic of China
| | - Hong-Lian Zhou
- Department of Ultrasound Diagnostics, Guangdong Province, The Affiliated Hospital of Guangdong Medical University, 57th, Renmin South Road, Xia shan District, Zhanjiang, 524001, People's Republic of China
| | - Li-Juan Liu
- Department of Ultrasound Diagnostics, Guangdong Province, The Affiliated Hospital of Guangdong Medical University, 57th, Renmin South Road, Xia shan District, Zhanjiang, 524001, People's Republic of China.
| | - Ming-Yi Li
- Department of Hepatobiliary Surgery, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, People's Republic of China
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7
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Spontaneous Rupture of a Hepatic Cavernous Hemangioma: A Rare Case of Sudden Unexpected Death. Am J Forensic Med Pathol 2020; 41:138-140. [PMID: 32379098 DOI: 10.1097/paf.0000000000000552] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Cavernous hemangiomas represent the most common benign tumors affecting the liver. They are more often asymptomatic and usually diagnosed through radiological examinations performed for other reasons. When there are symptomatic, they may cause digestive disorders such as abdominal pain, nausea, vomiting, or a palpable mass. Sudden death may occur as a result of rupture and bleeding. Spontaneous rupture of cavernous hepatic hemangioma is a rare complication, but the mortality rate is high. We report a rare case of sudden unexpected death of a 46-year-old woman due to a spontaneous rupture of a giant hepatic cavernous hemangioma discovered at autopsy.
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8
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Zhai LL, Ju TF, Zhou CH, Xie Q. Spontaneous rupture of giant hepatic hemangioma: misdiagnosis as gastrointestinal perforation. J Int Med Res 2019; 47:4514-4521. [PMID: 31429347 PMCID: PMC6753571 DOI: 10.1177/0300060519866624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Hepatic hemangioma is a frequent nonmalignant tumor in the human liver. Although
rupture of hepatic hemangioma is a rare complication, it may have serious
consequences. In this report, we describe a 56-year-old woman who underwent
laparoscopic surgery and open surgery for sudden abdominal pain and peritonitis.
Gastrointestinal perforation was prioritized before surgery according to the
patient’s symptoms, signs, and radiological report. A giant dark red mass
connected to the left liver by a pedicle was unexpectedly found during
intraoperative exploration. Hemoperitoneum was also found. Conversely, no
gastrointestinal perforation was found during intraoperative exploration. The
mass was successfully removed, and the hemoperitoneum was resolved.
Postoperative pathological examination showed that the mass was a hepatic
hemangioma. Ultimately, the patient was diagnosed with spontaneous rupture of a
giant hepatic hemangioma.
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Affiliation(s)
- Lu-Lu Zhai
- Department of General Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.,Department of General Surgery, Hangzhou First People's Hospital, Nanjing Medical University, Hangzhou, People's Republic of China
| | - Tong-Fa Ju
- Department of General Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.,Department of General Surgery, Hangzhou First People's Hospital, Nanjing Medical University, Hangzhou, People's Republic of China
| | - Chun-Hua Zhou
- Department of General Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.,Department of General Surgery, Hangzhou First People's Hospital, Nanjing Medical University, Hangzhou, People's Republic of China
| | - Qi Xie
- Department of General Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.,Department of General Surgery, Hangzhou First People's Hospital, Nanjing Medical University, Hangzhou, People's Republic of China
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9
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Chan S, Tan H. A Rare Presentation of Sudden Death due to Pulmonary Thromboembolism Possibly as a Result of Giant Hepatic Hemangioma. J Forensic Sci 2019; 64:1921-1925. [DOI: 10.1111/1556-4029.14080] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 04/26/2019] [Accepted: 04/29/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Shijia Chan
- Forensic Medicine Division Health Sciences Authority 11 Outram Rd Singapore 169078 Singapore
| | - Huimin Tan
- Department of Pathology National University Hospital National University Hospital (S) Pte Ltd 5 Lower Kent Ridge Rd Singapore 119074 Singapore
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10
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Pandit N, Awale L, Chaudhary S, Jaiswal LS. Fever of unknown origin: a rare presentation of giant hepatic hemangioma. J Surg Case Rep 2018; 2018:rjy143. [PMID: 29942486 PMCID: PMC6007685 DOI: 10.1093/jscr/rjy143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 06/01/2018] [Indexed: 11/13/2022] Open
Abstract
Hepatic hemangioma is mostly asymptomatic and incidental finding on imaging. Fever of unknown origin as a sole presentation is rare. We present an interesting case report of a 49-year-old female, who presented with fever for three months. Extensive blood investigations and infectious workup failed to reveal the cause. Contrast computed tomography of abdomen revealed a giant (15 × 11 cm) hemangioma arising from left lateral segment of liver, and was attributed as a cause for fever. Surgical excision of hemangioma completely ameliorated the fever.
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Affiliation(s)
- Narendra Pandit
- Surgical Gastroenterology Division, Department of Surgery, B P Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - Laligen Awale
- Surgical Gastroenterology Division, Department of Surgery, B P Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - Samir Chaudhary
- Surgical Gastroenterology Division, Department of Surgery, B P Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
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