Heme-Pigment Induced Acute Kidney Injury after Cavernous Hemangioma Ablation

摘要

Cavernous hemangiomas are the most common benign liver mass, occurring with up to 7.3% incidence.1 Giant cavernous hemangiomas—defined as those exceeding 5 cm in diameter —can stretch the liver capsule and prompt abdominal pain in approximately 40% of patients.2 Radio frequency ablation (RFA) is employed to treat symptomatic cavernous hemangiomas, and has shown superior effectiveness at alleviating pain—as well as shorter procedure time and reduced blood loss—in comparison to traditional open surgical resection.3 Acute kidney injury (AKI) is a rare complication of RFA of giant cavernous hemangiomas. This complication, which is due to heme-pigment released in the setting of massive red blood cell (RBC) hemolysis during the procedure, is uncommon, having been described in only a few cases in the literature.4'5 Herein, we present an illustrative case of AKI following RFA of a giant cavernous hemangioma requiring hospitalization and aggressive intravenous (IV) hydration, and we discuss risk factors, diagnostic criteria, avoidance strategies, and management approaches for this uncommon adverse event.