Spontaneous internal hemorrhage of a giant hepatic hemangioma with infection: a case report and literature review

Abstract

Spontaneous internal hemorrhage from a hepatic hemangioma is rare. This case describes a 59-year-old woman who was hospitalized with recurrent cough and fever for 6 months. The doctor thought that she had pneumonia, but other infectious diseases could not be ruled out. Therefore, related tests were performed and strong antibiotics were used, but the symptom of fever was persistent and recurred. Enhanced computed tomography (CT) findings showed a right hepatic giant hemangioma with hemorrhage, while tuberculosis, liver abscess, and immune disease were excluded by the physician. Because the patient’s fever was associated with a large hepatic hemangioma, the patient was transferred to surgery. During treatment, the amount of bleeding increased, so she underwent a right hepatic hemangioma resection in the emergency department. Her postoperative fever symptoms subsequently resolved. Pathological examination confirmed hemorrhagic necrosis with infection in hepatic hemangioma. Follow-up showed that the patient was afebrile.

Transarterial embolization for rare spontaneous subacute intratumoral hemorrhage of hepatic hemangioma: a case report and literature review

“…It was diagnosed as hepatic hemangioma with intratumoral hemorrhage. Finally, the symptoms disappeared after surgical resection ( 11 ).…”

“…It was diagnosed as hepatic hemangioma with intratumoral hemorrhage. Finally, the symptoms disappeared after surgical resection (11). Hepatic hemangioma can be diagnosed by ultrasound, CT, MRI, angiography, positron emission tomography (PET) and other imaging techniques, and the diagnostic accuracy exceeds 90% (21).…”

“…Compared to spontaneous rupture hemorrhage, intratumoral hemorrhage of hepatic hemangiomas is even rarer. Globally, only nine cases have been reported since 1993 ( 4 - 12 ) ( Table 1 ), of which only three cases received accurate preoperative diagnosis ( 5 , 7 , 11 ). Therefore, clinicians lack in-depth understanding of the diagnosis and treatment.…”

Giant hepatic hemangioma treatment with transcatheter arterial embolisation and transcatheter arterial chemoembolisation; Comparative results

“…Since then, in adults, TAE has been used to treat diffuse hemangiomatosis and symptomatic hemangiomas [ 4 ]. Several cases have been reported where TAE of ruptured giant hemangiomas prior to emergency surgery have been performed [ 17 , 18 ]. TAE has also been used to treat Kasabach–Merritt syndrome, following which coagulopathy is reported to be quickly reversed [ 19 , 20 ].…”

Giant Hepatic Hemangioma Causing Prolonged Fever and Indicated for Resection

“…Fever improved over 28 days with observation. Most cases resolved after <1 month by resection (4,(16)(17)(18)(19)(20), whereas some experienced >3 months of fever (15,(21)(22)(23)(24) (Table 2). The possibility of hepatic hemangioma with necrosis or bleeding may have caused fever.…”