SURGICAL EXPERIENCE OF MULTIPLE CAVERNOUS HEMANGIOMA OF THE LIVER WITH KASABACH-MERRITT SYNDROME

We experienced a case of multiple cavernous hemangioma of the liver with Kasabach-Merritt syndrome. A 38-year-old female with the chief complaint of an abdominal mass visited our hospital for further examination. An analysis of blood coagulation revealed moderate coagulopathy. Abdominal CT scan study revealed a huge tumor occupying left lobe of the liver, with a diameter of 30 cm. Selective celiac arteriography revealed a huge tumor with cotton wool-like pooling. A diognosis of hemangioma of the liver with Kasabach-Merritt syndrome was made, and extended left hepatic lobectomy was performed. The resected liver was 3090 g in weight and 30×21×12 cm in dimension. Histopathological diagnosis was typical cavernous hemangioma. Postoperative course has been no trouble for 18 months after operation, and coagulopathy has improved.Forty-two hemangiomas of the liver with Kasabach-Merritt syndrome in adults, which included this case, have been reported in Japan. Twenty-one cases were treated by hepatectomy, and had good prognosis. Therefore, active attitude for operation can be recommended in the treatment of hemangiomas of the liver with Kasabach-Merritt syndrome as far as we can perform.