Abstract
Five cases of hepatic haemangioma are described, and a sixth (previously reported) is reviewed. Clinical features, investigation, and management are described to show the great variability of the complications and prognosis. Five children presented in the first 10 weeks of life with hepatomegaly; 4 developed congestive cardiac failure; 3 had cutaneous haemangiomata. One child presented at age 4 years with hepatomegaly and anaemia, and on investigation had features of chronic disseminated intravascular coagulation. Focal decrease or patchiness in hepatic uptake of technetium-99m colloid, and abnormal intrahepatic circulation was shown in all cases. In 3 children liver biopsy was performed to exclude malignant disease. In one patient there was spontaneous regression of the tumour by age 3 years. In 3 cases hepatic artery ligation was necessary to control congestive cardiac failure which had persisted despite treatment with digoxin, diuretics, and oral corticosteroids, a procedure which was without complications after up to 8 years. One infant with intractable portal hypertension, hepatic vein obstruction, and severe cholestasis died with persisting alimentary haemorrhage and intra-abdominal sepsis. One child aged 4 years showed no immediate response to hepatic artery ligation but the size of her tumour got smaller and the clinical features diminished after irradiation. These tumours cause considerable morbidity and have a high reported mortality. If congestive cardiac failure is not rapidly controlled, hepatic artery ligation should be performed.
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- Alpert L. I., Benisch B. Hemangioendothelioma of the liver associated with microangiopathic hemolytic anemia. Report of four cases. Am J Med. 1970 May;48(5):624–628. doi: 10.1016/0002-9343(70)90013-6. [DOI] [PubMed] [Google Scholar]
- Blanchard H., St-Onge G., Guérin R., Turmel Y., Gervais M., Collin P. P. Hémangiome caverneux symptomatique du foie chez le nouveau-né. Rapport d'un cas traité chirurgicalement avec succéss et revue de littérature. Union Med Can. 1972 Aug;101(8):1536–1543. [PubMed] [Google Scholar]
- Braun P., Ducharme J. C., Riopelle J. L., Davignon A. Hemangiomatosis of the liver in infants. J Pediatr Surg. 1975 Feb;10(1):121–126. doi: 10.1016/s0022-3468(75)80020-0. [DOI] [PubMed] [Google Scholar]
- Burman D., Mansell P. W., Warin R. P. Miliary haemangiomata in the newborn. Arch Dis Child. 1967 Apr;42(222):193–197. doi: 10.1136/adc.42.222.193. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gralnick H. R., Givelber H., Abrams E. Dysfibrinogenemia associated with hepatoma. Increased carbohydrate content of the fibrinogen molecule. N Engl J Med. 1978 Aug 3;299(5):221–226. doi: 10.1056/NEJM197808032990503. [DOI] [PubMed] [Google Scholar]
- LEE C. M., Jr, NEWSTEDT J. R., SIDDALL H. S. Large abdominal tumors of childhood; other than Wilms' tumor or neuroblastoma. Ann Surg. 1956 Jun;143(6):803-13; discussion, 814-5. doi: 10.1097/00000658-195606000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Langer B., Stone R. M., Colapinto R. F., Meindok H., Phillips M. J., Fisher M. M. Clinical spectrum of the Budd-Chiari syndrome and its surgical management. Am J Surg. 1975 Feb;129(2):137–145. doi: 10.1016/0002-9610(75)90289-5. [DOI] [PubMed] [Google Scholar]
- Leonidas J. C., Strauss L., Beck A. R. Vascular tumors of the liver in newborns. A pediatric emergency. Am J Dis Child. 1973 Apr;125(4):507–510. doi: 10.1001/archpedi.1973.04160040025005. [DOI] [PubMed] [Google Scholar]
- Matolo N. M., Johnson D. G. Surgical treatment of hepatic hemangioma in the newborn. Arch Surg. 1973 May;106(5):725–727. doi: 10.1001/archsurg.1973.01350170085023. [DOI] [PubMed] [Google Scholar]
- McLean R. H., Moller J. H., Warwick W. J., Satran L., Lucas R. V., Jr Multinodular hemangiomatosis of the liver in infancy. Pediatrics. 1972 Apr;49(4):563–573. [PubMed] [Google Scholar]
- Mowat A. P., Gutjahr P., Portmann B., Dawson J. L., Williams R. Focal nodular hyperplasia of the liver: a rational approach to treatment. Gut. 1976 Jul;17(7):492–494. doi: 10.1136/gut.17.7.492. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Park W. C., Rhillips R. The role of radiation therapy in the management of hemangiomas of the liver. JAMA. 1970 Jun 1;212(9):1496–1498. [PubMed] [Google Scholar]
- Rake M. O., Liberman M. M., Dawson J. L., Evans R., Raftery E. B., Laws J., Williams R. Ligation of the hepatic artery in the treatment of heart failure due to hepatic haemangiomatosis. Gut. 1970 Jun;11(6):512–515. doi: 10.1136/gut.11.6.512. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rocchini A. P., Rosenthal A., Issenberg H. J., Nadas A. S. Hepatic hemangioendothelioma: hemodynamic observations and treatment. Pediatrics. 1976 Jan;57(1):131–135. [PubMed] [Google Scholar]
- Sardemann H., Tygstrup I. Prolonged obstructive jaundice and haemangiomatosis. Report of 2 cases. Arch Dis Child. 1974 Aug;49(8):665–667. doi: 10.1136/adc.49.8.665. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Smith W. L., Ballantine T. V., Gonzalez-Curssi F. Hepatic mesenchymal hamartoma causing heart failure in the neonate. J Pediatr Surg. 1978 Apr;13(2):183–185. doi: 10.1016/s0022-3468(78)80018-9. [DOI] [PubMed] [Google Scholar]
- Touloukian R. J. Hepatic hemangioendothelioma during infancy: pathology, diagnosis and treatment with prednisone. Pediatrics. 1970 Jan;45(1):71–76. [PubMed] [Google Scholar]
- Wishnick M. M. Multinodular hemangiomatosis with partial biliary obstruction. J Pediatr. 1978 Jun;92(6):960–962. doi: 10.1016/s0022-3476(78)80377-1. [DOI] [PubMed] [Google Scholar]
- deLorimier A. A., Simpson E. B., Baum R. S., Carlsson E. Hepatic-artery ligation for hepatic hemangiomatosis. N Engl J Med. 1967 Aug 17;277(7):333–337. doi: 10.1056/NEJM196708172770703. [DOI] [PubMed] [Google Scholar]






