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A case of primary hepatic epithelioid hemangioendothelioma with spontaneous rupture

자연파열을 동반한 간의 원발 상피모양혈관내피종 1예

Kim, Geum-Ha;Kim, Yun-Soo;Kim, Hyun-Ok;Kim, Kil-Hyun;Hung, Young-Kul;Jung, Dong-Hae;Kim, Jeong-Ho;Kwon, Oh-Sang;Choi, Duck-Joo;Kim, Ju-Hyun
김금하;김연수;김현옥;김길현;정영걸;정동해;김정호;권오상;최덕주;김주현

  • Published : 20091200

Abstract

Primary hepatic epithelioid hemangioendothelioma is a rare neoplasm of endothelial origin. The clinical manifestations are nonspecific, ranging from complete absence of symptoms to hepatic failure and death. Spontaneous rupture of a hepatic epithelioid hemangioendothelioma is an extremely rare presentation. We present a case of primary hepatic epithelioid hemangioendothelioma in a 65-year-old male patient with alcoholic liver cirrhosis. He was hospitalized due to epigastric pain and multiple liver masses on abdominal ultrasound. Dynamic liver CT imaging revealed multiple peripheral nodular enhanced mass lesions with delayed centripetal enhancement, and the adjacent collection of high-attenuation fluid along the liver capsule. Abdominal tapping revealed blood in the peritoneal cavity. Primary hepatic epithelioid hemangioendothelioma with spontaneous rupture was finally diagnosed based on a histopathologic examination revealing positive immunohistochemical staining for CD34.

간의 상피모양혈관내피종은 혈관 내피에서 기원하는 악성 종양이다. 임상증상은 무증상인 경우가 많고 복통, 체중감소, 피로감 등 비특이적이다. 다수의 간내 종괴를 형성하며 간혈관종과 유사한 조영소견을 보이고 복강 내로 자발 파열은 매우 드물다고 보고되고 있다. 저자들은 복통과 간내 다수의 종괴로 전원된 65세 남성에서 간의 상피모양혈관 내피종을 진단하고 간과 비장종괴가 파열되어 혈성 복수를 형성한 1예를 경험하였기에 문헌고찰과 함께 보고한다.

Keywords

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