In utero sonographic findings of giant hepatic hemangioma and associated perinatal complications: A report of two cases
Hiromi Imai, Nobuhiro Hidaka, Takeshi Murakami, Saki Kido, Yasuo Yumoto, Kotaro Fukushima, Kiyoko Kato
Comprehensive Maternity & Perinatal Care Center
Reproductive and Developmental Medicine
It is uncommon to diagnose fetal hepatic hemangioma during the antenatal period. We describe herein two patients with a giant hepatic hemangioma detected antenatally, both with perinatal complications. In Case 1, a fetal intra-abdominal mass, measuring 63mm×50mm×74mm, was observed below the right lobe of the liver, and the presumptive antenatal diagnosis of hepatic hemangioma was made at 37weeks of gestation. Antenatal imaging suggested an intratumoral hemorrhage, but postnatal clinical findings refuted this diagnosis. However, progressive thrombocytopenia and coagulopathy were noted just after birth, resulting in the diagnosis of Kasabach-Merritt syndrome. In Case 2, our ultrasound examination performed at 40weeks of gestation revealed a mixed solid and cystic hepatic tumor, measuring 99mm×54mm. Further, antenatal sonography revealed cardiomegaly, increased descending-aorta velocity, atrioventricular valvular regurgitation, and a dilated inferior vena cava, suggesting high-output cardiac insufficiency. Giant hepatic hemangiomas can lead to severe complications such as cardiac insufficiency and Kasabach-Merritt syndrome, and these complications may occur during the fetal or early neonatal period. Detailed prenatal evaluation using fetal imaging and cord-blood sampling is important to determine proper antenatal management of patients with giant hepatic hemangiomas and to allow for prompt postnatal treatment.
Journal of Medical Ultrasound
https://doi.org/10.1016/j.jmu.2014.10.005
Kasabach-Merritt Syndrome
Cordocentesis
High Cardiac Output
Cardiomegaly
Inferior Vena Cava
Imai, H., Hidaka, N., Murakami, T., Kido, S., Yumoto, Y., Fukushima, K., & Kato, K. (2015). In utero sonographic findings of giant hepatic hemangioma and associated perinatal complications: A report of two cases. Journal of Medical Ultrasound, 23(1), 46-51. https://doi.org/10.1016/j.jmu.2014.10.005
In utero sonographic findings of giant hepatic hemangioma and associated perinatal complications : A report of two cases. / Imai, Hiromi; Hidaka, Nobuhiro; Murakami, Takeshi; Kido, Saki; Yumoto, Yasuo; Fukushima, Kotaro; Kato, Kiyoko.
In: Journal of Medical Ultrasound, Vol. 23, No. 1, 01.03.2015, p. 46-51.
Imai, H, Hidaka, N, Murakami, T, Kido, S, Yumoto, Y, Fukushima, K & Kato, K 2015, 'In utero sonographic findings of giant hepatic hemangioma and associated perinatal complications: A report of two cases', Journal of Medical Ultrasound, vol. 23, no. 1, pp. 46-51. https://doi.org/10.1016/j.jmu.2014.10.005
Imai H, Hidaka N, Murakami T, Kido S, Yumoto Y, Fukushima K et al. In utero sonographic findings of giant hepatic hemangioma and associated perinatal complications: A report of two cases. Journal of Medical Ultrasound. 2015 Mar 1;23(1):46-51. https://doi.org/10.1016/j.jmu.2014.10.005
Imai, Hiromi ; Hidaka, Nobuhiro ; Murakami, Takeshi ; Kido, Saki ; Yumoto, Yasuo ; Fukushima, Kotaro ; Kato, Kiyoko. / In utero sonographic findings of giant hepatic hemangioma and associated perinatal complications : A report of two cases. In: Journal of Medical Ultrasound. 2015 ; Vol. 23, No. 1. pp. 46-51.
@article{36f8ab5a0b804f4ca7a8b11d4d858076,
title = "In utero sonographic findings of giant hepatic hemangioma and associated perinatal complications: A report of two cases",
abstract = "It is uncommon to diagnose fetal hepatic hemangioma during the antenatal period. We describe herein two patients with a giant hepatic hemangioma detected antenatally, both with perinatal complications. In Case 1, a fetal intra-abdominal mass, measuring 63mm×50mm×74mm, was observed below the right lobe of the liver, and the presumptive antenatal diagnosis of hepatic hemangioma was made at 37weeks of gestation. Antenatal imaging suggested an intratumoral hemorrhage, but postnatal clinical findings refuted this diagnosis. However, progressive thrombocytopenia and coagulopathy were noted just after birth, resulting in the diagnosis of Kasabach-Merritt syndrome. In Case 2, our ultrasound examination performed at 40weeks of gestation revealed a mixed solid and cystic hepatic tumor, measuring 99mm×54mm. Further, antenatal sonography revealed cardiomegaly, increased descending-aorta velocity, atrioventricular valvular regurgitation, and a dilated inferior vena cava, suggesting high-output cardiac insufficiency. Giant hepatic hemangiomas can lead to severe complications such as cardiac insufficiency and Kasabach-Merritt syndrome, and these complications may occur during the fetal or early neonatal period. Detailed prenatal evaluation using fetal imaging and cord-blood sampling is important to determine proper antenatal management of patients with giant hepatic hemangiomas and to allow for prompt postnatal treatment.",
author = "Hiromi Imai and Nobuhiro Hidaka and Takeshi Murakami and Saki Kido and Yasuo Yumoto and Kotaro Fukushima and Kiyoko Kato",
doi = "10.1016/j.jmu.2014.10.005",
journal = "Journal of Medical Ultrasound",
publisher = "Elsevier (Singapore) Pte Ltd",
T1 - In utero sonographic findings of giant hepatic hemangioma and associated perinatal complications
T2 - A report of two cases
AU - Imai, Hiromi
AU - Hidaka, Nobuhiro
AU - Murakami, Takeshi
AU - Kido, Saki
AU - Yumoto, Yasuo
AU - Fukushima, Kotaro
AU - Kato, Kiyoko
N2 - It is uncommon to diagnose fetal hepatic hemangioma during the antenatal period. We describe herein two patients with a giant hepatic hemangioma detected antenatally, both with perinatal complications. In Case 1, a fetal intra-abdominal mass, measuring 63mm×50mm×74mm, was observed below the right lobe of the liver, and the presumptive antenatal diagnosis of hepatic hemangioma was made at 37weeks of gestation. Antenatal imaging suggested an intratumoral hemorrhage, but postnatal clinical findings refuted this diagnosis. However, progressive thrombocytopenia and coagulopathy were noted just after birth, resulting in the diagnosis of Kasabach-Merritt syndrome. In Case 2, our ultrasound examination performed at 40weeks of gestation revealed a mixed solid and cystic hepatic tumor, measuring 99mm×54mm. Further, antenatal sonography revealed cardiomegaly, increased descending-aorta velocity, atrioventricular valvular regurgitation, and a dilated inferior vena cava, suggesting high-output cardiac insufficiency. Giant hepatic hemangiomas can lead to severe complications such as cardiac insufficiency and Kasabach-Merritt syndrome, and these complications may occur during the fetal or early neonatal period. Detailed prenatal evaluation using fetal imaging and cord-blood sampling is important to determine proper antenatal management of patients with giant hepatic hemangiomas and to allow for prompt postnatal treatment.
AB - It is uncommon to diagnose fetal hepatic hemangioma during the antenatal period. We describe herein two patients with a giant hepatic hemangioma detected antenatally, both with perinatal complications. In Case 1, a fetal intra-abdominal mass, measuring 63mm×50mm×74mm, was observed below the right lobe of the liver, and the presumptive antenatal diagnosis of hepatic hemangioma was made at 37weeks of gestation. Antenatal imaging suggested an intratumoral hemorrhage, but postnatal clinical findings refuted this diagnosis. However, progressive thrombocytopenia and coagulopathy were noted just after birth, resulting in the diagnosis of Kasabach-Merritt syndrome. In Case 2, our ultrasound examination performed at 40weeks of gestation revealed a mixed solid and cystic hepatic tumor, measuring 99mm×54mm. Further, antenatal sonography revealed cardiomegaly, increased descending-aorta velocity, atrioventricular valvular regurgitation, and a dilated inferior vena cava, suggesting high-output cardiac insufficiency. Giant hepatic hemangiomas can lead to severe complications such as cardiac insufficiency and Kasabach-Merritt syndrome, and these complications may occur during the fetal or early neonatal period. Detailed prenatal evaluation using fetal imaging and cord-blood sampling is important to determine proper antenatal management of patients with giant hepatic hemangiomas and to allow for prompt postnatal treatment.
U2 - 10.1016/j.jmu.2014.10.005
DO - 10.1016/j.jmu.2014.10.005
JO - Journal of Medical Ultrasound
JF - Journal of Medical Ultrasound
10.1016/j.jmu.2014.10.005