Peritoneal cavernous hemangiomatosis:A case report
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摘要
BACKGROUND Cavernous hemangiomatosis in the liver and spleen has been reported, but it occurs less commonly in the peritoneum. Here we report a case of peritoneal cavernous hemangiomatosis and share some valuable information about this disease.CASE SUMMARY A 57-year-old Chinese man had a huge abdominal mass with abdominal distention and a significant reduction of food consumption. An enhanced abdominal and pelvic computed tomography and positron emission tomography–computed tomography revealed multiple cystic masses on the peritoneum, greater omentum, small intestinal mesentery and the surface of the spleen, and a high maximum standardized uptake value of the largest cystic lesion. Exploratory laparotomy was performed, and multiple cystic masses were found on the surface of the peritoneum, greater omentum, mesentery of the small intestine, and surface of the liver and spleen. Dark red bloody cystic fluid was present in the cystic tumor. Pathological examination showed that in the stromal components, the irregular vascular wall was thin. The vessel lumen was interlinked, and the lumen was lined with flat endothelium. According to the intraoperative findings and pathologic results, the patient was diagnosed with peritoneal cavernous hemangiomatosis.CONCLUSION The possibility of peritoneal cavernous hemangiomatosis should be considered when multiple cystic masses are found in the abdominal cavity by preoperative examination.
BACKGROUND Cavernous hemangiomatosis in the liver and spleen has been reported, but it occurs less commonly in the peritoneum. Here we report a case of peritoneal cavernous hemangiomatosis and share some valuable information about this disease.CASE SUMMARY A 57-year-old Chinese man had a huge abdominal mass with abdominal distention and a significant reduction of food consumption. An enhanced abdominal and pelvic computed tomography and positron emission tomography–computed tomography revealed multiple cystic masses on the peritoneum, greater omentum, small intestinal mesentery and the surface of the spleen, and a high maximum standardized uptake value of the largest cystic lesion. Exploratory laparotomy was performed, and multiple cystic masses were found on the surface of the peritoneum, greater omentum, mesentery of the small intestine, and surface of the liver and spleen. Dark red bloody cystic fluid was present in the cystic tumor. Pathological examination showed that in the stromal components, the irregular vascular wall was thin. The vessel lumen was interlinked, and the lumen was lined with flat endothelium. According to the intraoperative findings and pathologic results, the patient was diagnosed with peritoneal cavernous hemangiomatosis.CONCLUSION The possibility of peritoneal cavernous hemangiomatosis should be considered when multiple cystic masses are found in the abdominal cavity by preoperative examination.
BACKGROUND Cavernous hemangiomatosis in the liver and spleen has been reported, but it occurs less commonly in the peritoneum. Here we report a case of peritoneal cavernous hemangiomatosis and share some valuable information about this disease.CASE SUMMARY A 57-year-old Chinese man had a huge abdominal mass with abdominal distention and a significant reduction of food consumption. An enhanced abdominal and pelvic computed tomography and positron emission tomography–computed tomography revealed multiple cystic masses on the peritoneum, greater omentum, small intestinal mesentery and the surface of the spleen, and a high maximum standardized uptake value of the largest cystic lesion. Exploratory laparotomy was performed, and multiple cystic masses were found on the surface of the peritoneum, greater omentum, mesentery of the small intestine, and surface of the liver and spleen. Dark red bloody cystic fluid was present in the cystic tumor. Pathological examination showed that in the stromal components, the irregular vascular wall was thin. The vessel lumen was interlinked, and the lumen was lined with flat endothelium. According to the intraoperative findings and pathologic results, the patient was diagnosed with peritoneal cavernous hemangiomatosis.CONCLUSION The possibility of peritoneal cavernous hemangiomatosis should be considered when multiple cystic masses are found in the abdominal cavity by preoperative examination.
引文
1 Ribback S,Thiele A,Rosenberg C,Friesecke S,Neumann V,Tannapfel A,Dombrowski F.Nodular hemangiomatosis of pleura and peritoneum.Pathol Res Pract 2011;207:718-721[PMID:21978481 DOI:10.1016/j.prp.2011.08.006]
2 Guerra A,Infante A,Rinninella E,Spinelli I,Mazziotti MA,De Gaetano AM,Pompili M,Bonomo L.Apeculiar case of diffuse hemangiomatosis of the left hepatic lobe in an asymptomatic adult patient:case report and literature review.Eur Rev Med Pharmacol Sci 2017;21:1593-1597[PMID:28429345]
3 Steininger H,Pfofe D,Marquardt L,Sauer H,Markwat R.Isolated diffuse hemangiomatosis of the spleen:case report and review of literature.Pathol Res Pract 2004;200:479-485[PMID:15310152 DOI:10.1016/j.prp.2004.04.004]
4 Takeda A,Ito H,Nakamura H.Large Omental Cystic Lymphangioma Masquerading as Mucinous Ovarian Neoplasia in an 8-Year-Old Premenarchal Girl:The Findings from Diagnostic Imaging and Laparoscopic-Assisted Excision.J Pediatr Adolesc Gynecol 2017;30:659-662[PMID:28629796 DOI:10.1016/j.jpag.2017.06.003]
5 Hejmadi RK,Gey van Pittius D,Stephens M,Chasty R,Braithwaite M.Angiolymphoid hyperplasia with eosinophilia(epithelioid haemangioma)occurring within multiple deep lymph nodes and presenting with weight loss and raised CA-125 levels.Virchows Arch 2006;448:366-368[PMID:16315021 DOI:10.1007/s00428-005-0119-8]
6 Weissferdt A,Moran CA.Epithelioid hemangioendothelioma of the bone:a review and update.Adv Anat Pathol 2014;21:254-259[PMID:24911250 DOI:10.1097/PAP.0000000000000027]
7 Putra J,Gupta A.Kaposiform haemangioendothelioma:a review with emphasis on histological differential diagnosis.Pathology 2017;49:356-362[PMID:28438388 DOI:10.1016/j.pathol.2017.03.001]
8 Cashell J,Smink GM,Helm K,Xavier F.Kaposiform hemangioendothelioma with Kasabach-Merritt phenomenon in an infant:Successful treatment with prednisolone,vincristine,and addition of sirolimus.Pediatr Blood Cancer 2018;65:e27305[PMID:30070028 DOI:10.1002/pbc.27305]
9 Nizri E,Baratti D,Guaglio M,Sinukumar S,Cabras A,Kusamura S,Deraco M.Multicystic mesothelioma:Operative and long-term outcomes with cytoreductive surgery and hyperthermic intra peritoneal chemotherapy.Eur J Surg Oncol 2018;44:1100-1104[PMID:29703622 DOI:10.1016/j.ejso.2018.03.004]
10 Shimizu Y,Komura T,Seike T,Omura H,Kumai T,Kagaya T,Ohta H,Kawashima A,Harada K,Kaneko S,Unoura M.A case of an elderly female with diffuse hepatic hemangiomatosis complicated with multiple organic dysfunction and Kasabach-Merritt syndrome.Clin J Gastroenterol 2018;11:411-416[PMID:29845554 DOI:10.1007/s12328-018-0871-3]
11 Fanburg JC,Meis-Kindblom JM,Rosenberg AE.Multiple enchondromas associated with spindle-cell hemangioendotheliomas.An overlooked variant of Maffucci's syndrome.Am J Surg Pathol 1995;19:1029-1038[PMID:7661276 DOI:10.1097/00000478-199509000-00006]
12 Wang ZK,Wang FY,Zhu RM,Liu J.Klippel-Trenaunay syndrome with gastrointestinal bleeding,splenic hemangiomas and left inferior vena cava.World J Gastroenterol 2010;16:1548-1552[PMID:20333801DOI:10.3748/wjg.v16.i12.1548]
13 Akcam M,Pirgon O,Salman H,Kockar C.Multiple gastrointestinal hemangiomatosis successfully treated with propranolol.J Pediatr Gastroenterol Nutr 2015;60:e16[PMID:23575304 DOI:10.1097/MPG.0b013e31829530af]
14 Bosemani T,Puttgen KB,Huisman TA,Tekes A.Multifocal infantile hepatic hemangiomas--imaging strategy and response to treatment after propranolol and steroids including review of the literature.Eur JPediatr 2012;171:1023-1028[PMID:22234480 DOI:10.1007/s00431-011-1671-7]
2 Guerra A,Infante A,Rinninella E,Spinelli I,Mazziotti MA,De Gaetano AM,Pompili M,Bonomo L.Apeculiar case of diffuse hemangiomatosis of the left hepatic lobe in an asymptomatic adult patient:case report and literature review.Eur Rev Med Pharmacol Sci 2017;21:1593-1597[PMID:28429345]
3 Steininger H,Pfofe D,Marquardt L,Sauer H,Markwat R.Isolated diffuse hemangiomatosis of the spleen:case report and review of literature.Pathol Res Pract 2004;200:479-485[PMID:15310152 DOI:10.1016/j.prp.2004.04.004]
4 Takeda A,Ito H,Nakamura H.Large Omental Cystic Lymphangioma Masquerading as Mucinous Ovarian Neoplasia in an 8-Year-Old Premenarchal Girl:The Findings from Diagnostic Imaging and Laparoscopic-Assisted Excision.J Pediatr Adolesc Gynecol 2017;30:659-662[PMID:28629796 DOI:10.1016/j.jpag.2017.06.003]
5 Hejmadi RK,Gey van Pittius D,Stephens M,Chasty R,Braithwaite M.Angiolymphoid hyperplasia with eosinophilia(epithelioid haemangioma)occurring within multiple deep lymph nodes and presenting with weight loss and raised CA-125 levels.Virchows Arch 2006;448:366-368[PMID:16315021 DOI:10.1007/s00428-005-0119-8]
6 Weissferdt A,Moran CA.Epithelioid hemangioendothelioma of the bone:a review and update.Adv Anat Pathol 2014;21:254-259[PMID:24911250 DOI:10.1097/PAP.0000000000000027]
7 Putra J,Gupta A.Kaposiform haemangioendothelioma:a review with emphasis on histological differential diagnosis.Pathology 2017;49:356-362[PMID:28438388 DOI:10.1016/j.pathol.2017.03.001]
8 Cashell J,Smink GM,Helm K,Xavier F.Kaposiform hemangioendothelioma with Kasabach-Merritt phenomenon in an infant:Successful treatment with prednisolone,vincristine,and addition of sirolimus.Pediatr Blood Cancer 2018;65:e27305[PMID:30070028 DOI:10.1002/pbc.27305]
9 Nizri E,Baratti D,Guaglio M,Sinukumar S,Cabras A,Kusamura S,Deraco M.Multicystic mesothelioma:Operative and long-term outcomes with cytoreductive surgery and hyperthermic intra peritoneal chemotherapy.Eur J Surg Oncol 2018;44:1100-1104[PMID:29703622 DOI:10.1016/j.ejso.2018.03.004]
10 Shimizu Y,Komura T,Seike T,Omura H,Kumai T,Kagaya T,Ohta H,Kawashima A,Harada K,Kaneko S,Unoura M.A case of an elderly female with diffuse hepatic hemangiomatosis complicated with multiple organic dysfunction and Kasabach-Merritt syndrome.Clin J Gastroenterol 2018;11:411-416[PMID:29845554 DOI:10.1007/s12328-018-0871-3]
11 Fanburg JC,Meis-Kindblom JM,Rosenberg AE.Multiple enchondromas associated with spindle-cell hemangioendotheliomas.An overlooked variant of Maffucci's syndrome.Am J Surg Pathol 1995;19:1029-1038[PMID:7661276 DOI:10.1097/00000478-199509000-00006]
12 Wang ZK,Wang FY,Zhu RM,Liu J.Klippel-Trenaunay syndrome with gastrointestinal bleeding,splenic hemangiomas and left inferior vena cava.World J Gastroenterol 2010;16:1548-1552[PMID:20333801DOI:10.3748/wjg.v16.i12.1548]
13 Akcam M,Pirgon O,Salman H,Kockar C.Multiple gastrointestinal hemangiomatosis successfully treated with propranolol.J Pediatr Gastroenterol Nutr 2015;60:e16[PMID:23575304 DOI:10.1097/MPG.0b013e31829530af]
14 Bosemani T,Puttgen KB,Huisman TA,Tekes A.Multifocal infantile hepatic hemangiomas--imaging strategy and response to treatment after propranolol and steroids including review of the literature.Eur JPediatr 2012;171:1023-1028[PMID:22234480 DOI:10.1007/s00431-011-1671-7]