Giant Hepatic Hemangioma With Kasabach–Merritt Syndrome: Is the Appropriate Treatment Enucleation or Liver Transplantation?

摘要

We present a case of giant cavernous hemangioma ofthe liver with disseminated intravascular coagulopathy(Kasabach–Merritt syndrome) which wascured by enucleation. The 51 year old womanpresented with increased abdominal girth and easybruisability. Workup elsewhere revealed a massivehepatic hemangioma and she was started on radiationtherapy to the lesion and offered an orthotopicliver transplant. After careful preoperative preparation,we felt that resection was possible and sheunderwent a successful enucleation. The operationand postoperative course were complicated bybleeding but she recovered and remains well infollowup after 6 months. All coagulation parametershave returned to normal. Enucleation shouldbe considered the treatment of choice for hepatichemangiomas, including those presenting withKasabach–Merritt syndrome. The benefits of enucleationas compared to liver transplantation forthese lesions are discussed.