title: Recurrent giant hemangioma causing severe respiratory distress.
abstract: Hemangioma is a common benign tumor of the liver that is usually asymptomatic. If >4 cm (giant hemangioma), it could present symptoms related to bleeding, thrombosis, consumptive coagulopathy, or adjacent abdominal organ compression. If symptomatic surgical treatment should be considered, liver resection as well as enucleation are considered. Recurrences after surgical resection are rare. We herein present a case of woman admitted to the emergency room for acute severe respiratory distress. She had undergone 2 surgical resections of liver hemangiomas. The respiratory syndrome, as showed by chest x-ray, computed tomography scan, and nuclear magnetic resonance imaging, was related to a recurrent giant multiple hemangioma, creating a prominent compression of right lung with left mediastinal shift and left heart dislocation. It resulted in pulmonary parenchymal compression associated with reduced chest wall compliance and increased pulmonary pressure. The patient was not eligible for surgical treatment because of the disease extension and her clinical conditions. She died 6 months later from respiratory insufficiency and hypercapnic coma.
authors.affiliation: Department of Surgery, San Gerardo Hospital, II University of Milan, Bicocca, via Donizetti 106, 20052 Monza, Italy. fabrizio.romano@unimib.it
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Romano
authors.forename: Grazia
authors.initials: G
authors.lastname: Messinesi
authors.forename: Francesco
authors.initials: F
authors.lastname: Tana
authors.forename: Franco
authors.initials: F
authors.lastname: Uggeri
mesh_terms: D003251:Constriction, Pathologic; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D006391:Hemangioma / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000209:etiology*; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed