A case Report of Giant Hemangioma of the Liver with the Risk of Shifting to Kasabach-Merritt Syndrome

Youich Tohyama, Yoshinori Inagaki, Satoru Yanagisawa, Masaru Naruse, Akihiko Itou, Haruyuki Akita, Kaoru Mizusaki, Tomoyoshi Okamoto, Takemasa Cho, Jun Tanaka, Hiroshi Nimura, Ryunosuke Ogawa, Tuneo Takahashi, Teruaki Aoki

Second Department of Surgery, Jikei University School of Medicine

We report a giant hemangioma of the liver with an excised specimen weighing of 4.3 kg, the second largest in Japan in the past 10 years, which meaning not clear Kasabach-Merritt syndrome. A 43-year-old woman, who complained of abdominal fullness and an elevated right diaphragm that was found in a periodic checkup, was admitted to our hospital for a detailed examination. Findings by percussion examination indicated that the lungliver border was elevated to the third intercosta. The tumor, which had a smooth surface and elastic hard consistency, was palpable 2 finger-breadths below the umbilical portion. Laboratory data suggested coagulative and fibrinolytic disorders (platelet count 13×10⁴/mm³, prothrombin time 53%, thrombin time 33%, fibrinogen 112 mg/dl, fibrin degradation products 40 µg/ml), but other laboratotry data were within normal limits. Findings by medical imagings and hepatic arterial angiography also indicated a giant hemangioma of the liver. Extended right lobectomy of the liver was performed. The operative findings showed that the tumor occupied all of the right lobe and the quadrate lobe of the liver. The resected specimen weighed 4.3 kg and histological findings revealed a cavernous hemangioma with hemangioendothelioma.

Key words
giant hemangioma of the liver, Kasabach-Merritt syndrome, indication of surgical treatment

Reprint requests
Youichi Tohyama Second Department of Surgery, Jikei University School of Medicine
3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105 JAPAN

Accepted
September 9, 1992

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