title: Successful liver resection in a giant hemangioma with intestinal obstruction after embolization.
abstract: Hepatic hemangiomas are the most common benign tumor of the liver. Most hepatic hemangiomas remain asymptomatic and require no treatment. Giant hepatic hemangiomas with established complications, diagnostic uncertainty and incapacitating symptoms, however, are generally considered an absolute indication for surgical resection. We present a case of a giant hemangioma with intestinal obstruction following transcatheter arterial embolization, by which the volume of the hemangioma was significantly reduced, and it was completely resected by a left hepatectomy. A 21-year-old Asian man visited our hospital for left upper quadrant pain. Examinations at the first visit revealed a left liver hemangioma occupying the abdominal cavity, with a maximum diameter of 31.5 cm. Embolization of the left hepatic artery was performed and confirmed a decrease in its size. However, the patient was readmitted to our hospital one month after embolization for intestinal obstruction. A left hepatectomy was completed through a herringbone incision, and safely removed a giant hemangioma of 26.5 cm × 19.5 cm × 12.0 cm in size and 3690 g in weight. Pre-operative arterial embolization is effective for reducing tumor size, but a close follow-up to decide the time for hepatectomy is important.
authors.affiliation: Department of Hepato-Biliary-Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Ji-Xiang
authors.initials: JX
authors.lastname: Zhou
authors.forename: Ji-Wei
authors.initials: JW
authors.lastname: Huang
authors.forename: Hong
authors.initials: H
authors.lastname: Wu
authors.forename: Yong
authors.initials: Y
authors.lastname: Zeng
mesh_terms: D004621:Embolization, Therapeutic; D006391:Hemangioma / Q000150:complications / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D006498:Hepatectomy; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000209:etiology*; D008113:Liver Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D011237:Predictive Value of Tests; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden; D055815:Young Adult
keywords: Complications; Hepatectomy; Hepatic hemangioma; Intestinal obstruction; Transcatheter arterial embolization