A successfully resected case of giant hepatic hemangioma with symptomatic massive pleural effusion: a case report.

Abstract

Giant hepatic hemangiomas can be symptomatic and develop complications, therefore, surgical interventions are considered for such cases. However, hepatic hemangioma presenting pleural effusion is extremely rare. The patient was a 68-year-old female presenting dyspnea, and was referred to our hospital for evaluation of giant hepatic hemangioma of 20 cm with right pleural effusion. Contrast-enhanced computed tomography showed a giant hepatic hemangioma, which stretched umbilical portion, right Glissonean pedicle, and middle hepatic vein and compressed inferior vena cava. The right diaphragm was cranially elevated. Massive pleural effusion was observed. We diagnosed as symptomatic giant hepatic hemangioma. Three days before surgery, right hepatic artery embolization was performed to reduce the tumor volume at the timing of surgery. Intraoperative findings revealed the tumor was severely adherent to the diaphragm and there were feeding arteries from there. Extended right hemihepatectomy with thoracic drainage were performed. The pathologic evaluation confirmed cavernous hemangioma. Postoperative courses were uneventful and the chest tube was removed on postoperative day 4. The patient was discharged on postoperative day 8. One month after the operation, she remained well without recurrence of pleural effusion. We herein report a successfully treated case of giant hepatic hemangioma with symptomatic massive pleural effusion.