Giant Hepatic Hemangioma With Kasabach&#8211;Merritt
Syndrome: Is the Appropriate Treatment
Enucleation or Liver Transplantation&#63;

Hochwald, Steven N.; Blumgart, Leslie H.

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HPB Surgery
Volume 11 (2000), Issue 6, Pages 413-419
doi:10.1155/2000/25954

Case Report

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

Steven N. Hochwald¹ and Leslie H. Blumgart²

¹Department of Surgery, University of Florida College of Medicine, Gainesville, Florida, USA
²Hepatobiliary Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York 10021, New York, USA

Received 22 October 1999

Copyright © 2000 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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.