title: Bilateral lower limb edema caused by compression of the retrohepatic inferior vena cava by a giant hepatic hemangioma.
abstract: Hemangiomas are the most common benign primary tumors of the liver and their prevalence ranges from 0.4% to 20%. Approximately 85% of hemangiomas are clinically asymptomatic and are incidentally detected in imaging studies performed for other causes. In a very small minority of patients, nausea, vomiting, abdominal pain, distension, palpable mass, obstructive jaundice, bleeding, and signs and symptoms of Budd-Chiari syndrome may develop due to compression of bile duct, hepatic vein, portal vein, and adjacent organs. Occasionally, external compression of inferior vena cava may lead to edema and/or indirect symptoms such as deep vein thrombosis of the lower limbs. In this report, we present a case of giant hepatic hemangioma that completely filled the right lobe of the liver. The patient presented with bilateral lower limb edema and pain. A computed tomography scan detected a 9 × 11 × 12 cm mass indicative of a hemangioma in the right lobe of the liver that compressed the inferior vena cava. The patient refused treatment initially but returned 6 months later presenting with the same symptoms. At that time, the mass had increased in size and a hepatectomy was performed, preserving the middle hepatic vein. By postoperative month 13, the swelling in the lower extremities had decreased significantly and the inferior vena cava appeared normal.
authors: 1 Department of Surgery, Inonu University Faculty of Medicine, Division of Liver Transplantation, Malatya, Turkey.
authors: Sami
authors: S
authors: Akbulut
authors: Mehmet
authors: M
authors: Yilmaz
authors: Aysegul
authors: A
authors: Kahraman
authors: Sezai
authors: S
authors: Yilmaz
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004487:Edema / Q000209:etiology*; D005260:Female; D006391:Hemangioma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D035002:Lower Extremity; D014057:Tomography, X-Ray Computed; D014682:Vena Cava, Inferior
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