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A hepatic sclerosed hemangioma with significant morphological change over a period of 10 years: a case report.

Shimada Y, Takahashi Y, Iguchi H, Yamazaki H, Tsunoda H, Watanabe M, Oda M, Yokomori H - J Med Case Rep (2013)

Bottom Line: Tumor markers carcinoembryonic antigen, alpha-fetoprotein, and CA19-9 levels in the peripheral blood were not elevated at any time.Segmental hepatectomy was performed.Immunochemically, the tumor cells were positive for CD34 and alpha smooth muscle actin.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Introduction: Liver cavernous hemangioma is the most common noncystic hepatic lesion, and a hemangioma that undergoes degeneration and fibrous replacement is called a hepatic sclerosed hemangioma.

Case presentation: A 63-year-old Japanese man was admitted for detailed investigation of a liver tumor. Tumor markers carcinoembryonic antigen, alpha-fetoprotein, and CA19-9 levels in the peripheral blood were not elevated at any time. Plain computed tomography showed an approximately 1.5 cm low density mass in the periphery of segment 8, which was marginally enhanced on contrast-enhanced dynamic computed tomography. On magnetic resonance imaging, the tumor was hypointense on T1-weighted image and hyperintense on T2-weighted image. The tumor was suspected to be an atypical hemangioma, metastatic, hepatocellular carcinoma, or cholangiocellular carcinoma. Segmental hepatectomy was performed. Histological examination of the resected tumor specimen revealed a sclerosed hemangioma with marked hyalinization and sparse stromal fibrosis. Immunochemically, the tumor cells were positive for CD34 and alpha smooth muscle actin. Electron microscopically, the residual hemangioma consisted of numerous caveolae and vesicles in endothelial cells in irregular shapes and sizes. Immunostaining for caveolin-1 showed decreased or no caveolin-1 reactivity in the hyalinized lesions of the sclerosed hemangioma, but abundant caveolin-1 reactivity in the residual cavernous hemangioma. Of interest, computed tomography images of the tumor obtained 10 years earlier at our hospital depicted a 3 cm typical cavernous hemangioma.

Conclusions: Hepatic sclerosed hemangioma is a rare condition. Comparison of radiological findings of the lesion over a period of 10 years was valuable in providing insight for the evolutional process from liver cavernous hemangioma to hepatic sclerosed hemangioma.

No MeSH data available.


Related in: MedlinePlus

Two-phase dynamic incremental computed tomography (CT) of the lesion performed 10 years ago. a: In the early phase CT image, the lesion in segment 8 shows peripheral high attenuation. b: The late phase CT image demonstrates homogeneous high attenuation. These images demonstrate the progressive, centripetal contrast enhancement in a liver cavernous hemangioma.
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Figure 7: Two-phase dynamic incremental computed tomography (CT) of the lesion performed 10 years ago. a: In the early phase CT image, the lesion in segment 8 shows peripheral high attenuation. b: The late phase CT image demonstrates homogeneous high attenuation. These images demonstrate the progressive, centripetal contrast enhancement in a liver cavernous hemangioma.

Mentions: CT images obtained from the same patient 10 years ago were available, and provided insight for the evolutional process from LCH (showing peripheral high attenuation in the early phase and homogeneous high attenuation in the late phase; Figure 7a and b) to HSH (showing peripheral high density in the arterial phase and subtle low density with focal capsular enhancement in the delayed phase; Figure 1).


A hepatic sclerosed hemangioma with significant morphological change over a period of 10 years: a case report.

Shimada Y, Takahashi Y, Iguchi H, Yamazaki H, Tsunoda H, Watanabe M, Oda M, Yokomori H - J Med Case Rep (2013)

Two-phase dynamic incremental computed tomography (CT) of the lesion performed 10 years ago. a: In the early phase CT image, the lesion in segment 8 shows peripheral high attenuation. b: The late phase CT image demonstrates homogeneous high attenuation. These images demonstrate the progressive, centripetal contrast enhancement in a liver cavernous hemangioma.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750244&req=5

Figure 7: Two-phase dynamic incremental computed tomography (CT) of the lesion performed 10 years ago. a: In the early phase CT image, the lesion in segment 8 shows peripheral high attenuation. b: The late phase CT image demonstrates homogeneous high attenuation. These images demonstrate the progressive, centripetal contrast enhancement in a liver cavernous hemangioma.
Mentions: CT images obtained from the same patient 10 years ago were available, and provided insight for the evolutional process from LCH (showing peripheral high attenuation in the early phase and homogeneous high attenuation in the late phase; Figure 7a and b) to HSH (showing peripheral high density in the arterial phase and subtle low density with focal capsular enhancement in the delayed phase; Figure 1).

Bottom Line: Tumor markers carcinoembryonic antigen, alpha-fetoprotein, and CA19-9 levels in the peripheral blood were not elevated at any time.Segmental hepatectomy was performed.Immunochemically, the tumor cells were positive for CD34 and alpha smooth muscle actin.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Introduction: Liver cavernous hemangioma is the most common noncystic hepatic lesion, and a hemangioma that undergoes degeneration and fibrous replacement is called a hepatic sclerosed hemangioma.

Case presentation: A 63-year-old Japanese man was admitted for detailed investigation of a liver tumor. Tumor markers carcinoembryonic antigen, alpha-fetoprotein, and CA19-9 levels in the peripheral blood were not elevated at any time. Plain computed tomography showed an approximately 1.5 cm low density mass in the periphery of segment 8, which was marginally enhanced on contrast-enhanced dynamic computed tomography. On magnetic resonance imaging, the tumor was hypointense on T1-weighted image and hyperintense on T2-weighted image. The tumor was suspected to be an atypical hemangioma, metastatic, hepatocellular carcinoma, or cholangiocellular carcinoma. Segmental hepatectomy was performed. Histological examination of the resected tumor specimen revealed a sclerosed hemangioma with marked hyalinization and sparse stromal fibrosis. Immunochemically, the tumor cells were positive for CD34 and alpha smooth muscle actin. Electron microscopically, the residual hemangioma consisted of numerous caveolae and vesicles in endothelial cells in irregular shapes and sizes. Immunostaining for caveolin-1 showed decreased or no caveolin-1 reactivity in the hyalinized lesions of the sclerosed hemangioma, but abundant caveolin-1 reactivity in the residual cavernous hemangioma. Of interest, computed tomography images of the tumor obtained 10 years earlier at our hospital depicted a 3 cm typical cavernous hemangioma.

Conclusions: Hepatic sclerosed hemangioma is a rare condition. Comparison of radiological findings of the lesion over a period of 10 years was valuable in providing insight for the evolutional process from liver cavernous hemangioma to hepatic sclerosed hemangioma.

No MeSH data available.


Related in: MedlinePlus