Heterotopic supradiaphragmatic livers are rare. A total of 23 cases of primary supradiaphragmatic livers have been reported in the literature. The clinical presentations of heterotopic supradiaphragmatic liver are var...Heterotopic supradiaphragmatic livers are rare. A total of 23 cases of primary supradiaphragmatic livers have been reported in the literature. The clinical presentations of heterotopic supradiaphragmatic liver are variable. The simultaneous detection of intrathoracic accessory liver and pulmonary sequestration is extremely rare, and only one case has previously been reported. It is difficult to make a correct diagnosis preoperatively. We presented a 53-year-old woman with complaints of an intermittent, productive cough and dyspnea for two months that was refractory to medical treatment. She had no previous history of trauma or surgery. A chest radiograph only showed a widening of the mediastinum. Contrast-enhanced computed tomography of the chest revealed a well-circumscribed homogenous soft-tissue mass, approximately 4.35 cm × 2.5 cm × 6.14 cm in size, protruding through the right diaphragmatic crura to the right pleural cavity, attached to the inferior vena cava, esophagus and liver. There was no conclusive diagnosis before surgery. After the operation, we discovered that this patient was the first case of a supradiaphragmatic heterotopic liver, which passed through the inferior vena cava foramen and was coincidentally combined with an intralobar pulmonary sequestration that was found intraoperatively. We discussed its successful management with surgical resection via a thoracic approach and reviewed the published literature.展开更多
BACKGROUND Osseous hemangiomas,especially those located in the manubrium,are rare benign tumors.In a review of the literature,only three case reports of sternal hemangioma were found.A precise diagnosis is difficult b...BACKGROUND Osseous hemangiomas,especially those located in the manubrium,are rare benign tumors.In a review of the literature,only three case reports of sternal hemangioma were found.A precise diagnosis is difficult because of their nonspecific findings on computed tomography(CT)/magnetic resonance imaging(MRI).CASE SUMMARY An 88-year-old woman was suffering from a progressively enlarging mass in the manubrium.Chest CT images showed an osteolytic and expansile lesion with cortical destruction.Vascular malformation was suspected after CT-guided biopsy.On the dynamic MRI scans,the mass showed a bright signal on the T2-weighted image,peripheral nodular enhancement on the early-phase images and progressive centripetal fill-in on the delayed-phase images.Cavernous hemangioma was suspected preoperatively based on the MRI features and finally confirmed by histopathologic analysis.CONCLUSION This uncommon case demonstrates the possible characteristic features of manubrium cavernous hemangioma on dynamic MRI scans;knowledge about these features may prevent patients from developing catastrophic complications,such as rupture or internal hemorrhage,caused by biopsy or surgery.展开更多
文摘Heterotopic supradiaphragmatic livers are rare. A total of 23 cases of primary supradiaphragmatic livers have been reported in the literature. The clinical presentations of heterotopic supradiaphragmatic liver are variable. The simultaneous detection of intrathoracic accessory liver and pulmonary sequestration is extremely rare, and only one case has previously been reported. It is difficult to make a correct diagnosis preoperatively. We presented a 53-year-old woman with complaints of an intermittent, productive cough and dyspnea for two months that was refractory to medical treatment. She had no previous history of trauma or surgery. A chest radiograph only showed a widening of the mediastinum. Contrast-enhanced computed tomography of the chest revealed a well-circumscribed homogenous soft-tissue mass, approximately 4.35 cm × 2.5 cm × 6.14 cm in size, protruding through the right diaphragmatic crura to the right pleural cavity, attached to the inferior vena cava, esophagus and liver. There was no conclusive diagnosis before surgery. After the operation, we discovered that this patient was the first case of a supradiaphragmatic heterotopic liver, which passed through the inferior vena cava foramen and was coincidentally combined with an intralobar pulmonary sequestration that was found intraoperatively. We discussed its successful management with surgical resection via a thoracic approach and reviewed the published literature.
文摘BACKGROUND Osseous hemangiomas,especially those located in the manubrium,are rare benign tumors.In a review of the literature,only three case reports of sternal hemangioma were found.A precise diagnosis is difficult because of their nonspecific findings on computed tomography(CT)/magnetic resonance imaging(MRI).CASE SUMMARY An 88-year-old woman was suffering from a progressively enlarging mass in the manubrium.Chest CT images showed an osteolytic and expansile lesion with cortical destruction.Vascular malformation was suspected after CT-guided biopsy.On the dynamic MRI scans,the mass showed a bright signal on the T2-weighted image,peripheral nodular enhancement on the early-phase images and progressive centripetal fill-in on the delayed-phase images.Cavernous hemangioma was suspected preoperatively based on the MRI features and finally confirmed by histopathologic analysis.CONCLUSION This uncommon case demonstrates the possible characteristic features of manubrium cavernous hemangioma on dynamic MRI scans;knowledge about these features may prevent patients from developing catastrophic complications,such as rupture or internal hemorrhage,caused by biopsy or surgery.
