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Infantile Hemangioendothelioma Of The Liver; Report Of Three Cases

Crocker & Clelland, 1957Other/Unknown

Pediatrics 19(4, part 1): Apr 1957; 596-605

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Abstract

Three consecutive young female patients with unresected liver cell adenoma and a history of contraceptive use of several years’ duration were followed up over a period of 2-4.5 years after withdrawal of hormonal medication. One patient presented multiple adenomas and in another, the adenoma was associated with a Budd-Chiari syndrome due to bilateral thrombotic hepatic vein occlusion. Complete regression of the adenomas was documented in all 3 patients by ultrasonography, liver radionuclide scan, laparoscopy, or computerized tomography. It is concluded that, in selected cases, conservative management after withdrawal of hormonal contraception may be a valid alternative to surgical therapy.

Case Details

Personal Characteristics

6-month-old pale, irritable, anoretic negro female

Clinical Characteristics

Abdominal mass, protuberant abdomen with a hard, nodular mass filling the right upper quadrant, most of the left upper quadrant, and extending below the umbilicus on the right. A raised hemangioma, 0.6 x 0.6 centimeters, was noted on the right lateral aspect of the neck. No icterus. Large density in the right upper abdomen. Displacement downward and medially of the right renal pelvis, without distortion. Concentration of hemoglobin was 5.7 gm/100 ml.

Remission Characteristics

Definite regression in size of the liver. The liver has remained small.

Treatment & Mechanisms

Proposed Remission Mechanisms

Not discussed

Clinical Treatment

Exploratory laparotomy

Additional Notes

The patient has remained in good health except for bronchial asthma. The anatomical diagnosis was infantile hemangioendothelioma of the liver.