A Case Report of Resection of Recurrent Hepatic Cavernous Hemangioma in the Anterior Segment Seven Years after the Primary Left Lobectomy

Koho Akimaru, Kiichiro Uchiyama, Izumi Iwase, Shigeru Imai, Masahiko Tanaka, Manabu Gotoh, Tasuku Shoji

The Second Department of Surgery, Nippon Medical School

A 52-year-old woman had a huge cavernous hemangioma of the left hepatic lobe with Kasabach-Merritt syndrome treated urgently with ligation of the left hepatic artery, left portal branch and left hepatic vein, and gauze tamponade over the partially dissected liver surface. Ten weeks later she underwent left hepatectomy for the necrotized hemangioma. She remained well for five years, when recurrence of the hemangioma was noted in the anterior segment on CT. Seven years after the hepatectomy, because of the relatively well-localized but growing hemangioma in the anterior segment, with preservation of liver function by the remaining posterior segment, resection for the recurrence was performed successfully. This patient is now well eleven months postoperatively. Strategies for giant cavernous hemangioma of the liver with bleeding tendency and for recurrence encircling the IVC are discussed.

Key words
Kasabach-Merritt syndrome, recurrence of hepatic cavernous hemangioma

Reprint requests
Koho Akimaru Department of Surgery, The First Hospital of Nippon Medical School
3-5-5 Iidabashi, Chiyoda-ku, Tokyo, 102 JAPAN

Accepted
November 11, 1992

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