Pregnancy after ovarian stimulation and intrauterine insemination in a woman with cavernous macrohemangioma of the liver. A case report.
BACKGROUND
There are only a few reports on cavernous hepatic hemangiomas after hormonal substitution or during pregnancy. So far, there have been no publications on ovulation stimulation in such patients.


METHODS
We report on a 31-year-old, asymptomatic, healthy woman with an incidental ultrasound finding of a cavernous macrohemangioma (diameter, 14 cm) of the liver. For treatment of primary infertility, clomiphene citrate therapy had been administered repeatedly in the past. Because these treatments were not successful and andrologic subfertility existed, homologous intrauterine insemination was recommended. The first treatment cycle with clomiphene citrate, human chorionic gonadotropin and subsequent intrauterine insemination was successful. During pregnancy, 2.5-cm growth of the liver hemangioma and a smaller, second lesion occurred but remained asymptomatic. Primary cesarean section was performed at 37 weeks' gestation to prevent rupture or hemorrhage of the hepatic hemangioma. Macrohemangiomas of the liver are associated with the risk of rupture and severe hemorrhage due to pressure during pregnancy and delivery.


CONCLUSIONS
During ovulation stimulation, pregnancy and the immediately postpartum period, there was no change in this benign tumor.
Spitzer
D
D
Department of Obstetrics and Gynecology, Salzburg General Hospital, Austria.
Krainz
R
R
Graf
A H
AH
Menzel
C
C
Staudach
A
A
D000328:Adult; D002585:Cesarean Section; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D002996:Clomiphene / Q000627:therapeutic use; D005260:Female; D005865:Gestational Age; D006392:Hemangioma, Cavernous / Q000000981:diagnostic imaging*; D006801:Humans; D007317:Insemination, Artificial, Homologous; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D010062:Ovulation Induction; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic; D014463:Ultrasonography
D006063:Chorionic Gonadotropin; D002996:Clomiphene