Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2020; 8(19): 4633-4643
Published online Oct 6, 2020. doi: 10.12998/wjcc.v8.i19.4633
Solitary hepatic lymphangioma mimicking liver malignancy: A case report and literature review
Xin Long, Lei Zhang, Qi Cheng, Qian Chen, Xiao-Ping Chen
Xin Long, Lei Zhang, Qi Cheng, Xiao-Ping Chen, Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Qian Chen, Endoscopic Unit, Department of Gastroenterology and Hepatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Author contributions: Long X collected primary data, searched the literature and drafted the manuscript; Zhang L involved in computed tomography images and pathology results; Cheng Q contributed to reviewing the manuscript, data analysis and table making; Chen Q critically reviewed and revised the manuscript; Chen XP conceived and designed the study; all authors read and approved the manuscript.
Informed consent statement: Informed consent statement was obtained from the patient and her family.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), prepared and revised the manuscript according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xiao-Ping Chen, MD, PhD, Professor, Surgeon, Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430030, Hubei Province, China. chenxpchenxp@163.com
Received: April 16, 2020
Peer-review started: April 16, 2020
First decision: July 25, 2020
Revised: August 3, 2020
Accepted: August 25, 2020
Article in press: August 25, 2020
Published online: October 6, 2020
Processing time: 164 Days and 17.4 Hours
Abstract
BACKGROUND

Hepatic lymphangioma, a malformation of the liver lymphatic system, is a rare benign neoplasm and usually coexists with other visceral lymphangiomas. Solitary hepatic lymphangioma is much more rarely seen and could cause a clinical misinterpretation as malignancy.

CASE SUMMARY

A 50-year-old woman with a liver mass of approximately 3.5 cm was initially diagnosed with hepatocellular carcinoma given the risk factors for liver cancer that she presented with, including Schistosome japonicum infection and jaundice, and also together with imaging results, which showed the mass enhanced quickly in the arterial phase and faded fast in the venous phase. The patient did not have the surgery first but received three rounds of transarterial chemoembolization because of her anxiety and fears for operation. Finally, the patient underwent laparoscopic liver segment 4b resection and cholecystectomy and was discharged from the hospital only 10 d after the operation. The pathological examination indicated the mass as hepatic lymphangioma. The patient has been followed up for 30 mo without recurrence. To raise the awareness of this misdiagnosed case and to better diagnose and treat this rare disease in future, we reviewed the published literature of solitary hepatic lymphangioma for its clinical symptoms, imaging presentation, operative techniques, histology features and prognosis.

CONCLUSION

Solitary hepatic lymphangioma mimicking malignancy makes diagnosis difficult. Complete surgical resection is the first choice to treat solitary hepatic lymphangioma.

Keywords: Hepatic lymphangioma, Hepatocellular carcinoma, Laparoscopic hepatectomy, Trans-arterial chemoembolization, Adult, Case report

Core Tip: Hepatic lymphangioma is an extremely rare benign neoplasm. We presented a case of solitary hepatic lymphangioma with a typical imaging performance of hepatocellular carcinoma, thus misdiagnosed as liver cancer and treated with transarterial chemoembolization for three rounds. Finally, the lesion was removed by liver resection and confirmed as lymphangioma in pathology. The patient recovered well and no recurrence was found during follow up. Published literature with solitary hepatic lymphangioma were reviewed and analyzed. Complete surgical resection is the first choice to treat solitary hepatic lymphangioma.