Complete Laparoscopic Resection of a Peculiarly Shaped Hepatic Hemangioma Difficult to Discriminate from a Gastric Submucosal Tumor

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  • Niwa Kazuya
    Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine
  • Enomoto Takeharu
    Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine
  • Mikami Shinya
    Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine
  • Igarashi Yosuke
    Department of Gastroenterology and Hepatology, St. Marianna University School of Medicine
  • Mafune Taichi
    Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine
  • Katsumata Kenta
    Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine
  • Tsukamoto Yoshitsugu
    Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine
  • Ida Keisuke
    Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine
  • Ogura Yuta
    Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine
  • Sasaki Natsuko
    Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine
  • Saji Osamu
    Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine
  • Matsushita Tsunehisa
    Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine
  • Hashimoto Kazuki
    Department of Radiology, St. Marianna University School of Medicine
  • Fujino Takashi
    Department of Pathology, St. Marianna University School of Medicine
  • Hoshikawa Masahiro
    Department of Pathology, St. Marianna University School of Medicine
  • Otsubo Takehito
    Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine

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Other Title
  • 胃粘膜下腫瘍との鑑別を要し腹腔鏡下に切除した肝外発育型肝血管腫の1例

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<p>The patient was a 54-year-old man referred to us for a gastric tumor revealed by abdominal computed tomography during an examination for ureteral calculi. Upper gastrointestinal gastroscopy suggested that something was pressing on the outside the stomach wall on the greater curvature of the stomach. Ultrasound revealed an 8-cm hypoechoic mass. The gastric lesion was suspected to be cancerous because the contrast effect continued to the 4th layer. We confirmed a vasogenic malignant tumor by MRI. PET/CT did not show any clear uptake of FDG. We therefore diagnosed a gastric submucosal tumor and frequent occurrence of liver hemangiomas. Because we could not confirm malignancy of the gastric lesion, we decided to perform a laparoscopic partial gastric resection. When we observed the abdominal cavity, no gastric submucosa tumor was seen, but we found numerous hepatic hemangiomas and a fibrous tumor on the outside of the liver, which we thought was the lesion revealed by CT. We thus performed a partial hepatic resection laparoscopically. The patient was discharged from the hospital on postoperative day 7. Histopathology revealed a nonmalignant hepatic hemangioma. We report a case of complete laparoscopic resection of peculiarly shaped hepatic hemangioma that was difficult to discriminate from a gastric submucosal tumor.</p>

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