title: A case of microhepatoma associated with schistosomiasis japonica diagnosed by enhanced ultrasonography after hepatic intraarterial injection of carbon dioxide gas.
abstract: The patient was a 58-year old man whose complaints were generalized malaise and right epigastralgia. He had liver cirrhosis and schistosomiasis japonica, previously diagnosed by laparoscopy. Computed tomography (CT) showed a high density funicular shadow in the liver. However no tumorous lesions in the liver were visualized. Ultrasonography (US) of the liver showed a reticulate or scaly pattern, but no images of tumorous lesions. Hepatic angiography showed a single, deeply colored image about 1cm in diameter, in the segmentum anterosuperior. Preoperative and intraoperative enhanced US with hepatic intraarterial injection of carbon dioxide gas was performed. It showed a hyperechoic tumor shadow about 1cm in the segmentum anterior. The segmentum anterosuperior including the tumor was partially resected. Pathologically, the tumor was found to be a hepatoma of Edmondson type II, caused by cirrhosis and schistosomiasis japonica. The patient's postoperative course was uneventful. Enhanced US with hepatic intraarterial injection of carbon dioxide gas was useful for the diagnosis and treatment of the microhepatoma associated with schistosomiasis japonica.
authors.affiliation: Department of Surgery, Tokai University Oiso Hospital, Kanagawa, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Mizutani
authors.forename: H
authors.initials: H
authors.lastname: Hanaue
authors.forename: Y
authors.initials: Y
authors.lastname: Tokuda
authors.forename: Y
authors.initials: Y
authors.lastname: Yanagida
authors.forename: O
authors.initials: O
authors.lastname: Chino
authors.forename: S
authors.initials: S
authors.lastname: Arakawa
authors.forename: F
authors.initials: F
authors.lastname: Ueno
authors.forename: H
authors.initials: H
authors.lastname: Makuuchi
authors.forename: T
authors.initials: T
authors.lastname: Tajima
authors.forename: T
authors.initials: T
authors.lastname: Mitomi
mesh_terms: D000792:Angiography; D002245:Carbon Dioxide / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006499:Hepatic Artery; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D012554:Schistosomiasis japonica / Q000150:complications*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D002245:Carbon Dioxide