1/22. Solitary hepatic hemangioma in a newborn infant complicated by cardiac failure, consumption coagulopathy, microangiopathic hemolytic anemia, and obstructive jaundice. Case report and review of the literature.A newborn infant with a large hepatic hemangioma developed congestive heart failure, consumption coagulopathy, microangiopathic hemolytic anemia, and obstructive jaundice. The patient was mildly heparinized (250 units per kg and day) and underwent successful resection of the tumor without lobectomy at the age of 3 days. blood volume increased from 93.9 ml/kg at the age of 5 h to 124.2 ml/kg prior to surgery. Red-cell mass simultaneously decreased from 53.8 to 39.4 ml/kg. The increase of blood volume is explained by congestive heart failure, the decrease of red-cell mass by intravascular coagulation within the tumor resulting in formation of thrombi and microangiopathic hemolytic anemia. A review of the literature on infants with symptoms caused by an intrahepatic hemangioma during the first month of life confirms that surgical intervention is the treatment of choice for infants with giant solitary hemangioma of the liver.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/22. kasabach-merritt syndrome with terminal gram negative infection.A case of giant haemangioma with disseminated intravascular coagulation (Kasabach-Merritt) syndrome) is presented. death occurred despite therapy and postmortem evidence of clinically unrecognised gram negative bacteraemia was seen.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/22. Giant hepatic hemangioma with kasabach-merritt syndrome: is the appropriate treatment enucleation or liver transplantation?We present a case of giant cavernous hemangioma of the liver with disseminated intravascular coagulopathy (kasabach-merritt syndrome) which was cured by enucleation. The 51 year old woman presented with increased abdominal girth and easy bruisability. Workup elsewhere revealed a massive hepatic hemangioma and she was started on radiation therapy to the lesion and offered an orthotopic liver transplant. After careful preoperative preparation, we felt that resection was possible and she underwent a successful enucleation. The operation and postoperative course were complicated by bleeding but she recovered and remains well in followup after 6 months. All coagulation parameters have returned to normal. Enucleation should be considered the treatment of choice for hepatic hemangiomas, including those presenting with kasabach-merritt syndrome. The benefits of enucleation as compared to liver transplantation for these lesions are discussed.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
4/22. Acute myeloid leukaemia with giant granules: association with t(10; 11)(p13; q14) and disseminated intravascular coagulation.A 16-year-old Chinese girl presented with AML-M5a. A bone marrow examination showed that the myeloblasts which were overwhelming the marrow contained giant granules (pseudo-Chediak-Higashi anomaly). Her karyotype showed a rare translocation t(10; 11)(p13; q14). Molecular delineation of the translocation breakpoints was not possible. Nonetheless, this case further demonstrates the morphological and phenotypic heterogeneity of acute leukaemia with this translocation. In this girl it was associated with disseminated intravascular coagulation.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
5/22. Treatment of kasabach-merritt syndrome by embolisation of a giant liver hemangioma.We report the case of a 14-month-old child with kasabach-merritt syndrome, due to a giant liver hemangioma. The therapeutic approach consisted of peripheral transcatheter embolisation of the right hepatic artery with Ivalon microspheres without the addition of thrombogenic material. This procedure brought to a sensible permanent reduction of the size of the liver hemangioma with normalisation of the previous altered coagulation parameters after 6 years of follow-up.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
6/22. Living donor liver transplantation for giant hepatic hemangioma with kasabach-merritt syndrome with a posterior segment graft.We present a case of a giant hepatic hemangioma with kasabach-merritt syndrome, which was cured by living donor liver transplantation. A 48-year-old woman complained of abdominal fullness and appetite loss. The laboratory data showed disseminated intravascular coagulation and a morphologic evaluation revealed a giant hepatic hemangioma involving both lobes of the liver. Living donor liver transplantation was indicated for kasabach-merritt syndrome and an unresectable liver tumor. A posterior segment graft was used because the remnant liver volume of the donor might have been too small to sustain the liver function of the donor. The postoperative course was uneventful, and the recipient was discharged from hospital on day 15 after the transplantation without complications.- - - - - - - - - - ranking = 6keywords = giant (Clic here for more details about this article) |
7/22. kasabach-merritt syndrome in two neonates.Two neonates with a giant hemangioma associated with thrombocytopenia (Kasabach-Marritt syndrome) have been managed at Kure National Hospital. The first case was initially difficult to distinguish from overwhelming infection or other tumors but improved after radiotherapy. The second case was resistant to radiation and steroid therapy. magnetic resonance imaging determined a tumor extending into the surrounding soft tissues better than did enhanced computed tomography. Subtotal excision of the tumor and various drugs were effective only transiently and 51Cr-labeled platelets sequestrated into the residual hemangioma. Severe thrombocytopenia persisted for approximately 15 months requiring extra care for head and body contusions, but finally improved by treatment with platelet-active drugs such as acetylsalicylic acid, dipyridamole, and pentoxifylline.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/22. A case of giant cavernous hemangioma of the liver complicated by intravascular coagulopathy.A case of liver hemangioma complicated by intravascular coagulopathy is presented because of the rarity of the association. hemangioma of the liver was suspected by palpation of the liver tumor, scintigraphy and x-ray examination, and confirmed by selective hepatic arteriography in combination with exploratory laparotomy. Intravascular coagulopathy was established by demonstrating secondary fibrinolysis and consumption of platelets and coagulation factors. Unconjugated hyperbilirubinemia due to micro-angiopathic hemolytic anemia was also present. The clinical course of the clotting abnormalities was basically a chronic one with an occasional acute or subacute defibrination process associated with further enlargement of the hepatic tumor. These provide sufficient evidence that the intravascular coagulopathy was closely related with the hemangioma in the liver. Neither ligation of a presumed nutritional artery of the hemangioma nor radiation therapy caused any demonstrable reduction in the tumor size.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
9/22. kasabach-merritt syndrome associated with giant liver hemangioma: the effect of combined therapy with danaparoid sodium and tranexamic acid.n patients with kasabach-merritt syndrome (KMS), local activation of coagulation commonly results in disseminated intravascular coagulation (DIC). Progress of DIC is associated with 30-40% mortality as a result of uncontrollable hemorrhage. A 39-year-old woman with an enlarging giant liver hemangioma was diagnosed as having KMS with DIC. To control the hemorrhagic diathesis, we commenced combination therapy for DIC with danaparoid (1,250 Ux2/day, intravenously (IV)) and tranexamic acid (0.5 g x 3/day, peros (PO). Rapid improvement of the bleeding tendency and coagulopathy occurred in response to this treatment - that is, DIC was controlled without removing the giant hemangioma. The therapy did not restrict the behavior of the patient by continuous drip and angiography could be performed without bleeding. Such therapy may be beneficial in chronic DIC with activation of fibrinolysis.- - - - - - - - - - ranking = 6keywords = giant (Clic here for more details about this article) |
10/22. Hepatic giant cavernous hemangioma with microangiopathic hemolytic anemia and consumption coagulopathy.We describe a case of hepatic giant cavernous hemangioma with both microangiopathic hemolytic anemia (MAHA) and consumption coagulopathy, but without thrombocytopenia, which was completely cured by surgical resection of the tumor. The patient was a 54-yr-old Japanese woman whose chief complaint was right upper abdominal discomfort. angiography and dynamic computed tomography revealed typical findings of hepatic cavernous hemangioma. The patient also had hematological disorders. At surgery, we performed an atypical right lobectomy to preserve as much normal liver tissue as possible. The patient has been well, with no related complaints or abnormal laboratory findings, 5 yr since her operation. This case indicates that giant cavernous hemangioma of the liver should be considered in the differential diagnosis of MAHA, and if surgical treatment is adequate, hematological abnormalities may be eliminated.- - - - - - - - - - ranking = 6keywords = giant (Clic here for more details about this article) |
| | Next -> |