A Resected Case of Sclerosing Hemangioma

Hiroya Iida, Yasuhisa Tango, Yoshihiro Tsutamoto, Takanori Harimura*, Kenji Tanaka*, Takashi Takao*, Hiroyuki Yuzawa*, Masamori Shimabuku*, Toshiomi Kusano* and Yasushi Irie**

Department of Surgery, Tenjinkai Koga Hospital 21
Department of Surgery, Sin-Koga Hospital*
Department of Pathology, Tenjinkai Koga Hospital 21**

A 77-year-old woman with epigastric pain undergoing upper gastrointestinal (GI) tract endoscopy elsewhere was found to have a protruding extramural lesion in the anterior wall of the middle gastric body and She was referred for further evaluation. Abdominal ultrasonography showed a space-occupying lesion of the liver (SOL) measuring 39 by 30 mm with an iso to high echo level. Abdominal computed tomography (CT) showed an enhanced heterogeneous SOL on the inside of the marginal portion of the tumor. Abdominal magnetic resonance imaging (MRI) showed a low signal SOL on a T1-weighted image and a high signal SOL on a T2-weighted image. A dynamic MRI study showed an internal heterogeneous image. No other GI tract examinations showed any abnormal findings. We first suspected the mass to be a cavernous hepatic hemangioma, but it was difficult to distinguish liver hemangioma accurately from intrahepatic bile duct carcinoma or metastatic liver tumor. In July 2004, we conducted laparoscopic-assisted partial hepatectomy. The tumor consisted of fibrous connective tissue and a cavernous hemangioma. Histopathological analysis yield a definitive diagnosis of liver-sclerosing hemangioma. Case reports of liver-sclerosing hemangioma are rare, and only 9 such cases have, to our knowledge, been described in the literature.

Key words
sclerosing hemangioma, cavernous angioma, liver

Reprint requests
Hiroya Iida Department of Surgery, Tenjinkai Koga Hospital 21
3-3-8 Miyanojin, Kurume, 839-0801 JAPAN

Accepted
February 22, 2006

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