BACKGROUND Hepatic hemangioma is the most common benign tumor of the liver.However,patients with large hemangiomas that cause compression symptoms or that are at risk of rupture may need further intervention.It is nec...BACKGROUND Hepatic hemangioma is the most common benign tumor of the liver.However,patients with large hemangiomas that cause compression symptoms or that are at risk of rupture may need further intervention.It is necessary to explore additional minimally invasive and personalized treatment options for hemangiomas.CASE SUMMARY A 47-year-old woman was diagnosed with a right hepatic hemangioma for more than 10 years.Abdominal contrast-enhanced computed tomography(CT)and contrast-enhanced ultrasound revealed that there was a large hemangioma in the right liver,with a size of approximately 95 mm×97 mm×117 mm.Due to the patient's refusal of surgical treatment,hepatic artery embolization was performed in the first stage.After 25 d of liver protection treatment,the liver function indexes decreased to normal levels.Then,ultrasound-guided microwave ablation of the giant hepatic hemangioma was performed.Ten days after the treatment,hepatobiliary ultrasonography showed that the hemangioma of the right liver was smaller than the previous size(the volume was reduced by approximately 30%).Then the patient was discharged from the hospital.One year after discharge,CT showed that the hepatic hemangioma had shrunk by about 80%CONCLUSION Transcatheter arterial embolization combined with microwave ablation is a safe and effective minimally invasive treatment for hepatic hemangioma.展开更多
基金Zhejiang Province Public Welfare Technology Application Research Project,No.LGF21H160022Project of Taizhou University,No.2018PY057+1 种基金Project of Taizhou Central Hospital,No.2019KT003Taizhou Social Development Science and Technology Plan Project,No.21ywb26 and No.21ywb29.
文摘BACKGROUND Hepatic hemangioma is the most common benign tumor of the liver.However,patients with large hemangiomas that cause compression symptoms or that are at risk of rupture may need further intervention.It is necessary to explore additional minimally invasive and personalized treatment options for hemangiomas.CASE SUMMARY A 47-year-old woman was diagnosed with a right hepatic hemangioma for more than 10 years.Abdominal contrast-enhanced computed tomography(CT)and contrast-enhanced ultrasound revealed that there was a large hemangioma in the right liver,with a size of approximately 95 mm×97 mm×117 mm.Due to the patient's refusal of surgical treatment,hepatic artery embolization was performed in the first stage.After 25 d of liver protection treatment,the liver function indexes decreased to normal levels.Then,ultrasound-guided microwave ablation of the giant hepatic hemangioma was performed.Ten days after the treatment,hepatobiliary ultrasonography showed that the hemangioma of the right liver was smaller than the previous size(the volume was reduced by approximately 30%).Then the patient was discharged from the hospital.One year after discharge,CT showed that the hepatic hemangioma had shrunk by about 80%CONCLUSION Transcatheter arterial embolization combined with microwave ablation is a safe and effective minimally invasive treatment for hepatic hemangioma.
文摘目的评价经导管动脉化疗栓塞术(TACE)联合微波消融(MWA)治疗原发性肝癌的有效性及安全性,为临床实践与研究提供参考。方法计算机检索Cochrane Library、Pub Med、EMbase、Web of Science、CBM、CNKI、Wan Fang及VIP 8个数据库,同时辅以其他检索,收集所有TACE联合MWA治疗原发性肝癌的随机对照试验(RCT)。评价员按照研究计划书进行文献筛选和资料提取,并对纳入文献进行质量评价后,使用Rev Man 5.3软件进行Meta分析。结果共纳入19篇RCT(1 356例患者)。Meta分析结果显示:1联合组0.5年、1年、1.5年、2年和3年的总生存率均明显好于TACE组,且其差异均有统计学意义(P<0.05);合并结果分别为0.5年[RR=1.24,95%CI=(1.12,1.37)],1年[RR=1.50,95%CI=(1.38,1.62)],1.5年[RR=2.05,95%CI=(1.38,3.06)],2年[RR=1.97,95%CI=(1.65,2.36)],3年[RR=3.39,95%CI=(2.32,4.96)]。2联合组的完全缓解率、总有效率、完全坏死率和甲胎蛋白(AFP)的转阴率均高于单独TACE组,联合组的复发率低于单独TACE组,且其差异均有统计学意义(P<0.05);合并结果分别为完全缓解率[RR=2.53,95%CI=(1.45,4.41)],总有效率[RR=1.69,95%CI=(1.43,1.99)],完全坏死率[RR=2.51,95%CI=(1.87,3.36)],AFP转阴率[RR=1.49,95%CI=(1.28,1.73)],复发率[RR=0.28,95%CI=(0.15,0.52)]。结论相比较单用TACE治疗,TACE联合MWA治疗原发性肝癌能提高患者近期疗效和远期生存率,降低复发率,且安全性仍较好。
