title: Superextended hepatectomy for resection of multiple giant hemangiomas: report of a case.
abstract: Most liver hemangiomas are small, asymptomatic, and require no treatment. Symptoms such as right upper quadrant abdominal pain and fullness are associated only with liver hemangiomas larger than 4 cm in diameter. Serious complications such as jaundice, Kasabach-Merritt syndrome, and rupture are rare. Surgical resection is the only effective treatment, but it is advocated only for patients with incapacitating symptoms or complications. We report a case of successful superextended hepatectomy with resection of segments III-VIII for multiple, bilobar hemangiomas. A 45-year-old woman, who had undergone transcatheter arterial embolization (TAE) for inoperable multiple giant liver hemangiomas 4 years earlier, was referred to our hospital for investigation of abdominal distension and consumption coagulopathy. Because of her severe and progressive symptoms despite treatment, the other hospital had considered her as a candidate for liver transplantation, which she had refused. After careful preoperative assessment of the future liver remnant volume and function, we considered that resection was possible. Based on our review of large surgical series in the literature from 1970, this is the first report of a superextended hepatectomy for a benign liver tumor.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Silvia
authors.initials: S
authors.lastname: Pachera
authors.forename: Hideki
authors.initials: H
authors.lastname: Nishio
authors.forename: Hideki
authors.initials: H
authors.lastname: Yamada
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Yokoyama
authors.forename: Tomoki
authors.initials: T
authors.lastname: Ebata
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Igami
authors.forename: Masato
authors.initials: M
authors.lastname: Nagino
mesh_terms: D005260:Female; D006392:Hemangioma, Cavernous / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008875:Middle Aged