Necrosis of a large hepatic tumor after hemorrhage and subsequent selective arterial embolization.
This case report describes a young female patient presenting with acute intra-abdominal hemorrhage originating from a large tumor in the liver, most likely a hepatocellular adenoma. The bleeding was stopped by selective embolization of right hepatic artery branches. Subsequently, partial hepatectomy was performed after 6 mo. Macro- and microscopic examination showed complete necrosis and absence of tumorous tissue. The patient was discharged without complications, and subsequent follow-up until 22 mo after resection did not reveal any new lesions in the liver. This case emphasizes the significance of selective arterial embolization in the management of bleeding liver tumors and questions the need for (partial) hepatectomy after this procedure in selective cases.
Huurman
Volkert A L
VA
Department of Surgery, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands.
Stoot
Jan H M B
JH
van der Linden
Edwin
E
Terpstra
Onno T
OT
Schaapherder
Alexander F M
AF
D018248:Adenoma, Liver Cell / Q000098:blood supply / Q000150:complications*; D000328:Adult; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy*; D006499:Hepatic Artery / Q000473:pathology; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000150:complications*; D009336:Necrosis / Q000473:pathology