Transarterial Chemoembolization as a Treatment for Super-Giant Hepatic Hemangioma

Paul Kokorowski

Department of Maxillofacial Surgery, Tokyo Medical and Dental University, Tokyo, Japan

Published Date: 2023-06-12
DOI10.36648/ipsdsc.8.2.89

Paul Kokorowski*

Department of Maxillofacial Surgery, Tokyo Medical and Dental University, Tokyo, Japan

*Corresponding Author:
Paul Kokorowski
Department of Maxillofacial Surgery,
Tokyo Medical and Dental University, Tokyo,
Japan,
E-mail:
kokorowski@tmdu.jp

Received date: May 12, 2023 Manuscript No. IPSDSC-23-17152; Editor assigned date: May 15, 2023, PreQC No. IPSDSC-23-171512 (PQ); Reviewed date: May 26, 2023, QC No. IPSDSC-23-17152; Revised date: June 05, 2023, Manuscript No. IPSDSC-23-17152 (R); Published date: June 12, 2023, DOI: 10.36648/ipsdsc.8.2.89

Citation: Kokorowski P (2023) Transarterial Chemoembolization as a Treatment for Super-Giant Hepatic Hemangioma. Skin Dis Skin Care: Vol.8 No. 2:89

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Description

Hepatic hemangiomas are normal harmless liver growths. The majority of hemangiomas are small and do not require treatment; however, giant hemangiomas are those that are larger than 4-6 cm in size and may necessitate treatment. In the past, giant hemangiomas that require intervention have been treated with surgical resection and enucleation. In addition, there is a dearth of information regarding the treatment of hemangiomas that are larger than 20 centimeters, particularly in relation to transarterial chemoembolization. In this case, transarterial chemoembolization alone was used to treat a super-giant hemangioma that measured more than 20 centimeters in diameter.

Transarterial Chemoembolization

The primary treatment for giant hemangiomas (hemangiomas larger than 4-6 cm) has traditionally been surgical resection and enucleation; however, there is a significant chance of complications, with a morbidity rate of between 21 and 27 percent. The treatment of hemangiomas larger than 20 centimeters, specifically the function of Transarterial Chemoembolization (TACE), is poorly documented. We report a case of a super-giant hemangioma that was treated with TACE alone and had a size and volume reduction of approximately 90%. The tumor measured more than 20 cm.

We present a case of a giant hepatic hemangioma that was successfully treated with TACE alone, despite the fact that the vast majority of asymptomatic hepatic hemangiomas do not require treatment. Hemangiomas can be treated safely and effectively with TACE. A meta-analysis of 21 studies with 1450 transarterial embolized patients found that lipiodol-based treatments significantly reduced the size of hemangiomas compared to Polyvinyl Alcohol (PVA)-based treatments, with a mean pre and post diameter of 9.8 to 2.6 cm and 6.0 to 1.4 cm, respectively. Essentially, Li et al. performed a retrospective analysis of 836 patients who had symptomatic hepatic hemangiomas and were treated with TACE with lipiodolpingyangmycin emulsion. The results showed that the patients experienced a 100% reduction in their symptoms and that the mean diameter of the hemangiomas decreased from 9.6 to 0.8 cm to 3.6 to 0.5 cm. We played out the TACE with lipiodolbleomycin emulsion rather than lipiodol-pingyangmycin since the last option isn't accessible in the US.

Lipiodol Pingyangmycin

When compared to surgical options, this case serves as a further illustration of a minimally invasive treatment option for even super-giant hemangiomas that is associated with minimal hospitalization and probably lower risk of major complications. The evidence that transarterial chemoembolization is a safe and effective treatment for large giant hemangiomas could benefit from additional investigation, in our opinion. Every single individual participant in the study gave their informed consent. There is no disclosure of patient identifiers. In healthy patients, no additional diagnostic tests should be performed in front of a hyperechoic round liver lesion with regular margins and smaller than 3 cm, according to various international guidelines. On the other hand, our clinical case demonstrates how an adenoma of the liver can be mistaken for a hyperechoic round lesion that is smaller than 3 cm and has all of the characteristics of a typical hemangioma. The rapid growth of the lesion after two years, which could only be detected with a follow-up, was the primary factor that raised suspicion. A further component of doubt was addressed by the utilization of estrogen treatment; In fact, subjects taking estrogen therapy should not follow up for hemangiomas or focal nodular hyperplasia because neither of these conditions has been shown to be associated with estrogen therapy.

EUS have a 85% sensitivity and a 85% specificity for diagnosing HCA. The receiver operating characteristic (ROC) area under the curve value was 0.856, as demonstrated by a recent study; and the negative predictive value was 90%, while the positive predictive value was 79%. The positive and negative predictive values for the diagnosis of HCA were 92% and 95%, respectively, for MRI using a liver-specific contrast agent, respectively. The ROC area under the curve value was 0.949. Consequently, MRI is the preferred imaging technique for detecting and evaluating liver hemangiomas. According to the most recent Italian intercompany guidelines, adult patients who have been diagnosed with hepatocellular adenoma and have a histological subtype that cannot be characterized by imaging methods should have a biopsy performed because it identifies the mutated beta-catenin adenoma, which is the form with the greatest risk of malignant transformation, and the sonic hedgehog adenoma, which is linked to a high risk of spontaneous bleeding. When the adenoma has been distinguished and analyzed, estrogenic treatment should be keep with ensuing development.

We believe that a CEUS examination or at least one follow-up examination should be conducted after the initial discovery of a liver lesion, even if it suggests hemangioma. A CEUS exam or at least a close follow-up should always be performed on women with additional risk factors, such as taking estrogen-based medications. Assessment and are portrayed by a reasonable harmless guess. On the other hand, in some cases, hemangiomas have an unusual appearance on both B-mode and Contrast-Enhanced Ultrasound (CEUS), which raises questions about how to differentiate them from adenomas and other malignant lesions. Neonato de 18 horas de vida con normales ecgrafas prenatales y antecedente materno de diabetes gestacional y preeclampsia, interconsultado por una mancha vascular extensa, presented with a liver lesion with all signs suggesting hemangioma in B-mode. Exhibited labioescrotal pliers containing internal testes and a micropen with interesting hipospadias. The previous year was extremely selfish, but it was also marked by effort. He had a lower extremity vascular anomaly, the perineum, and a lumbosacral region consistent with a segmental hemangioma as well as a lumbosacrocutaneal apex. A magnetic resonance was carried out prior to the diagnosis of the LUMBAR syndrome, which resulted in the identification of a lipomielocele and an annular medullary tumor. Moreover, next time we experience a comparable case, we will carry out an insignificant intrusive procedure. For the most part, there are no reports of repeat after resection of heart hemangioma, we will cautiously notice the postoperative course of this uncommon growth.

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