Das kavernöse Leberhämangiom: Rationale Diagnostik und therapeutisches Vorgehen

Gassel, H.‐J.; Klein, Ingo; Steger, Ulrich; Simon, Michael; Thiede, A.

doi:10.1055/s-2005-836314

Cited by 1 publication

(16 citation statements)

References 22 publications

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“…Based on the morphological and functional behavior of the various imaging procedures, the dignity of these lesions may partly be determined unambiguously [1–4, 18, 32–36, 38]. This assignment and classification is more difficult for patients with a positive malignant, non-hepatogenous history of tumor (especially in case of a colorectal and breast carcinoma).…”

Section: Discussionmentioning

confidence: 99%

“…These are usually diagnosed as asymptomatic incidental findings. In addition to nonspecific symptoms, hemangiomas also (rarely) rupture spontaneously or by trauma and then lead to acute hemorrhagic shock with upper abdominal pain [ 1 , 10 , 18 ]. In the worldwide literature a total of only 97 cases with a rupture of a hemangioma have been published, whereas a spontaneous rupture only happened in 47.4% of cases (46) [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

“…Further investigation showed that these spontaneously ruptured hemangiomas had a mean size of 11.2 cm [ 19 ]. In an acute situation, the immediate restitution of coagulation factors and rarely TAE are methods of choice [ 1 , 10 , 11 , 18 ]. TAE teatment of a hemangioma is difficult and due to the aberrant collateral arterial circulation making almost improbable to stop the multiple inflow from different feeding arteries especially through the periphery of the hemangiomas.…”

Section: Introductionmentioning

confidence: 99%

“…Several studies have concluded that a spontaneous rupture of a hemangioma (even while pregnancy) [ 10 , 19 ] occurs only very rarely, and therefore a prophylactic resection should only be conducted under special conditions and especially with a size of the hemangioma >11 cm [ 10 ]. In case of hemangiomas with high growth trend (>3 cm in 12 months), with symptomatic compression symptoms or recurrent pain, which may correlate with hemorrhage into the lesion, surgical intervention should be indicated [ 18 , 19 ]. Because of hypotension, unexplained anemia, or diagnosis difficulties of the liver lesion, surgical intervention can be rarely necessary.…”

Section: Introductionmentioning

confidence: 99%

“…Because of hypotension, unexplained anemia, or diagnosis difficulties of the liver lesion, surgical intervention can be rarely necessary. In exceptional cases, individual patient factors, such as an extreme carcinogenicity phobia or high risk of rupture due to a patients career, sometimes require a resection of the lesion [ 18 ]. Overall, the indication for surgical intervention should be found cautiously [ 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

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“Incidentaloma” of the Liver: Management of a Diagnostic and Therapeutic Dilemma

et al. 2012

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The continuous development of highly sensitive clinical imaging increased the detection of focal lesions of the liver. These accidentally detected liver tumors without liver-specific symptoms such as cholestasis have been named “incidentalomas.” Diagnostic tools such as sonography, computed tomography, or magnetic resonance imaging are used increasingly in asymptomatic individuals without defined suspected diagnoses in the setting of general prevention or followup after a history of malignancy. But despite continuous improvement of diagnostics, some doubt regarding the benign or malign behavior of a tumor remains. In case an asymptomatic hemangioma or FNH can be preoperatively detected with certainty, the indication for surgery must be very strict. In case of symptomatic liver lesions surgical resection should only be indicated with tumor-specific symptoms. In the remaining cases of benign lesions of the liver, a “watch and wait” strategy is recommended. In case of uncertain diagnosis, especially in patients with positive history of a malignant tumor or the suspected diagnosis of hepatocellular adenoma, surgical resection is indicated. Due to the continuous improvement of surgical techniques, liver resection should be done in the laparoscopic technique. Laparoscopic surgery has lower morbidity and shorter hospitalization than open technique.

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