Giant abdominal desmoid-type fibromatosis
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| Format: | Artículo científico |
| Language: | en |
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Hospital Universitário da Universidade de São Paulo
2024
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| author | Saikat Mitra |
| author_facet | Saikat Mitra |
| contents | Giant abdominal desmoid-type fibromatosis Saikat Mitra Amitava Dutta Medicina Hemangioma Case Reports Liver Cirrhosis Giant hepatic hemangiomas are occasional in patients with cirrhosis. It remains a challenge to decide on the need fortreatment and choose the most appropriate intervention. A 62-year-old woman was recently diagnosed with cirrhosis and complained of upper abdominal fullness, reduction in oral food intake, and weight loss of 6 kg over the last three years. Upper digestive endoscopy evidenced thin-caliber esophageal varices and significant extrinsic compression of the lesser gastric curvature. Abdominal computed tomography revealed an exophytic tumor in the left hepatic lobe, measuring 11.5 cm, which had progressive centripetal contrast enhancement from the arterial phase, compatible with hepatic hemangioma. Serum tumor markers were negative, and her liver function was unimpaired. The patient underwent surgical resection (non-anatomical hepatectomy of segments II and III) which had no immediate complications, and the histopathological evaluation confirmed cavernous hepatic hemangioma. Two weeks later, she was admitted to the emergency room with jaundice, signs of hepatic encephalopathy, and moderate ascites, and was further diagnosed with secondary bacterial peritonitis. As no perforations, abscesses, or fistulas were observed on subsequent imaging tests, clinical management was successfully carried out. This case highlights that giant hepatic hemangiomas may be symptomatic and warrant treatment. In the setting of cirrhosis and portal hypertension, physicians should be aware of the risk of hepatic decompensation following surgical resection, even in patients with Child-Pugh class A. 2024 otro 2236-1960 https://www.redalyc.org/articulo.oa?id=576077572004 https://www.redalyc.org/journal/5760/576077572004/ https://www.redalyc.org/journal/5760/576077572004/html/ https://www.redalyc.org/journal/5760/576077572004/576077572004.epub https://www.redalyc.org/journal/5760/576077572004/movil 10.4322/acr.2024.471 en http://www.redalyc.org/revista.oa?id=5760 Autopsy and Case Reports application/pdf Hospital Universitário da Universidade de São Paulo Autopsy and Case Reports (Brasil) Vol.14 |
| format | Artículo científico |
| id | redalyc_576077572004 |
| institution | Redalyc |
| language | en |
| publishDate | 2024 |
| publisher | Hospital Universitário da Universidade de São Paulo |
| spellingShingle | Giant abdominal desmoid-type fibromatosis Saikat Mitra Medicina Hemangioma Case Reports Liver Cirrhosis Giant abdominal desmoid-type fibromatosis Saikat Mitra Amitava Dutta Medicina Hemangioma Case Reports Liver Cirrhosis Giant hepatic hemangiomas are occasional in patients with cirrhosis. It remains a challenge to decide on the need fortreatment and choose the most appropriate intervention. A 62-year-old woman was recently diagnosed with cirrhosis and complained of upper abdominal fullness, reduction in oral food intake, and weight loss of 6 kg over the last three years. Upper digestive endoscopy evidenced thin-caliber esophageal varices and significant extrinsic compression of the lesser gastric curvature. Abdominal computed tomography revealed an exophytic tumor in the left hepatic lobe, measuring 11.5 cm, which had progressive centripetal contrast enhancement from the arterial phase, compatible with hepatic hemangioma. Serum tumor markers were negative, and her liver function was unimpaired. The patient underwent surgical resection (non-anatomical hepatectomy of segments II and III) which had no immediate complications, and the histopathological evaluation confirmed cavernous hepatic hemangioma. Two weeks later, she was admitted to the emergency room with jaundice, signs of hepatic encephalopathy, and moderate ascites, and was further diagnosed with secondary bacterial peritonitis. As no perforations, abscesses, or fistulas were observed on subsequent imaging tests, clinical management was successfully carried out. This case highlights that giant hepatic hemangiomas may be symptomatic and warrant treatment. In the setting of cirrhosis and portal hypertension, physicians should be aware of the risk of hepatic decompensation following surgical resection, even in patients with Child-Pugh class A. 2024 otro 2236-1960 https://www.redalyc.org/articulo.oa?id=576077572004 https://www.redalyc.org/journal/5760/576077572004/ https://www.redalyc.org/journal/5760/576077572004/html/ https://www.redalyc.org/journal/5760/576077572004/576077572004.epub https://www.redalyc.org/journal/5760/576077572004/movil 10.4322/acr.2024.471 en http://www.redalyc.org/revista.oa?id=5760 Autopsy and Case Reports application/pdf Hospital Universitário da Universidade de São Paulo Autopsy and Case Reports (Brasil) Vol.14 |
| title | Giant abdominal desmoid-type fibromatosis |
| topic | Medicina Hemangioma Case Reports Liver Cirrhosis |
| url | https://www.redalyc.org/articulo.oa?id=576077572004 https://www.redalyc.org/journal/5760/576077572004/ https://www.redalyc.org/journal/5760/576077572004/html/ https://www.redalyc.org/journal/5760/576077572004/576077572004.epub https://www.redalyc.org/journal/5760/576077572004/movil |