Case Report
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 7, 2014; 20(25): 8312-8316
Published online Jul 7, 2014. doi: 10.3748/wjg.v20.i25.8312
Right hepatectomy for giant cavernous hemangioma with diffuse hemangiomatosis around Glisson’s capsule
Yu Ohkura, Masaji Hashimoto, Seigi Lee, Kazunari Sasaki, Masamichi Matsuda, Goro Watanabe
Yu Ohkura, Masaji Hashimoto, Seigi Lee, Kazunari Sasaki, Masamichi Matsuda, Goro Watanabe, Department of Digestive Surgery, Hepato Pancreato Billiary Surgery Unit, Toranomon Hospital, Tokyo 105-8470, Japan
Author contributions: Ohkura Y and Hashimoto M contributed equally to this work; Ohkura Y and Hashimoto M designed and conducted the research, contributed new reagents and analytic tools, analyzed the data, and wrote the paper; Ohkura Y drafted the article, revised it critically for important intellectual content, and gave final approval; Ohkura Y, Hashimoto M, Lee S, Sasaki K, Matsuda M and Watanabe G created study materials or recruited patients.
Correspondence to: Yu Ohkura, MD, Department of Digestive Surgery, Hepato Pancreato Billiary Surgery Unit, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan. yu.ohkura107@gmail.com
Telephone: +81-3-35881111 Fax: +81-3-35827068
Received: January 21, 2014
Revised: February 27, 2014
Accepted: April 5, 2014
Published online: July 7, 2014
Processing time: 163 Days and 10.7 Hours
Abstract

Diffuse liver hemangiomatosis with giant cavernous hemangioma in adult is extremely rare. A 35 year-old woman presented to hospital with main complaint of epigastric pain and abdominal fullness. An enhanced computed tomography scan revealed a massive liver tumor in right lobe about 150 mm in size. There was contrast enhancement at the periphery of the mass consistent with a cavernous hemangioma. She underwent right hepatectomy. Histologically, it was diagnosed as a cavernous hemangioma. And also, hemangiomatous lesions were scattered around the Glisson’s capsule on the back ground liver. These hemangiomatous lesions were not recognized preoperatively. Even if we couldn’t diagnose hemangiomatosis around the main giant hemangioma preoperatively, we need to take enough surgical margins because the giant hemangioma has the potential to have small hemangiomatous lesions around the tumor. We reported right hepatectomy for giant cavernous hemangioma with diffuse hepatic hemangiomatosis without an extrahepatic lesion in an adult.

Keywords: Giant cavernous hemangioma; Hemangiomatosis; Right hepatectomy; Around Glisson’s capsule; Surgery

Core tip: A 35-year-old woman presented to the hospital complaining of epigastric pain and abdominal fullness. Imaging findings showed a giant cavernous hemangioma approximately 150 mm in size on right lobe of the liver. We performed right hepatectomy. Histologically, this entity was diagnosed as a cavernous hemangioma. Furthermore, hemangiomatous lesions were scattered around the Glisson’s capsule of normal liver. These hemangiomatous lesions were not recognized preoperatively. Even if we were unable to diagnose the hemangiomatosis around the giant hemangioma preoperatively, we still would have had to excise sufficiently large surgical margins, as giant hemangiomas may have small hemangiomatous lesions around the tumor.