Hepatic Hemangioma with Kasabach-Merritt Syndrome in an Adult Patient.
Hemangiomas are the most common benign tumors of the liver. They are generally asymptomatic, but giant hemangiomas can lead to abdominal discomfort, bleeding, or obstructive symptoms. Kasabach-Merritt syndrome is a rare but life-threatening complication of hemangioma, characterized by consumptive coagulopathy with large vascular tumors. More than 80% of Kasabach-Merritt syndrome cases occur within the first year of life. However, there are few reports of Kasabach-Merritt syndrome with giant hepatic hemangioma in adults and, as far as we know, no reports of Kasabach-Merritt syndrome with hepatic hemangioma treated with first line medical treatment only. The most important treatment for this syndrome is removal of the large vascular tumor. However, surgical treatment entails risk of bleeding, and the patient's condition can mitigate against surgery. We herein present a case of unresectable giant hepatic hemangioma with disseminated intravascular coagulopathy. The patient was a 60-year-old woman who complained of hematochezia, ecchymosis, and abdominal distension. She refused all surgical management and was therefore treated with systemic glucocorticoids and beta-blockers. After two weeks of steroid therapy, she responded partially to the treatment. Her laboratory findings and hematochezia improved. She was discharged on hospital day 33 and observed without signs of bleeding for three months.
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Chan Young
CY
Oak
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Chung Hwan
CH
Jun
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Eun Ae
EA
Cho
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Du Hyun
DH
Lee
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Sung Bum
SB
Cho
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Chang Hwan
CH
Park
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Young Eun
YE
Joo
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Hyun Soo
HS
Kim
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Jong Sun
JS
Rew
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Sung Kyu
SK
Choi
D000005:Abdomen / Q000000981:diagnostic imaging; D004438:Ecchymosis / Q000209:etiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006391:Hemangioma / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D059885:Kasabach-Merritt Syndrome / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D011433:Propranolol / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
D011433:Propranolol; D011241:Prednisone
Disseminated intravascular coagulation; Hemangioma; Kasabach-Merritt syndrome