Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
권호 표지

간동맥 색전술과 간엽 절제술로 치료한 영아 간내 혈관내피종 1례

A Case of Infantile Hemangioendothelioma of the Liver Treated with Hepatic Embolization and Lobectomy

  • 김재선 (을지의과대학교 노원을지병원 소아과) ;
  • 문수경 (을지의과대학교 노원을지병원 소아과) ;
  • 윤혜선 (을지의과대학교 노원을지병원 소아과) ;
  • 이태석 (을지의과대학교 노원을지병원 소아외과)
  • Kim, Jae Seon (Department of Pediatrics, School of Medicine, Eulji University) ;
  • Moon, Soo Kyung (Department of Pediatrics, School of Medicine, Eulji University) ;
  • Yoon, Hye Seon (Department of Pediatrics, School of Medicine, Eulji University) ;
  • Lee, Tae Seok (Department of Pediatric Surgery, School of Medicine, Eulji University)
  • 투고 : 2004.12.24
  • 심사 : 2005.03.08
  • 발행 : 2005.06.15
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

저자들은 신생아 시기에 심부전 증세를 보인 간내 혈관내피종 환아에서 내과적 치료와 간동맥 색전술 후 호전을 보이지 않아 간좌엽 절제술을 시행하여 치료한 1례를 경험하였기에 보고하는 바이다.

Infantile hemangioendothelioma(IHE) of the liver is the most common vascular tumor in infants before the age of 6 months. It is a histologically benign tumor with potentially life-threatening complications. The clinical manifestations are variable, ranging from asymptomatic forms to intractable high-output heart failure. In addition, abdominal mass, intraperitoneal hemorrhage due to rupture of mass, respiratory distress, hematologic abnormalities and jaundice can occur. Diagnostic work-up is through doppler ultrasound sonography, computed tomography scan, magnetic resonance imaging and angiography. Treatment consists of medical treatment, interventional therapy, surgical resection and liver transplantation. We experienced symptomatic IHE in a premature neonate who presented with high output heart failure and respiratory distress. Initial medical treatment and steroid therapy failed to improve his condition. Coil embolization of left hepatic artery resulted in improvement of respiratory symptoms. However, a left lobectomy was performed because the mass size was not decreased with development of collateral vessels. The infant was well, after a successful discharge from the hospital.

키워드

참고문헌

  1. Foote J. Hemangioendotheliosarcoma of the liver. JAMA 1919;73:1942-5
  2. Kim KT, Lee HK, Lee SY, Park YS, Kim KH, Kim YS. A case of hepatic hemangioendothelioma. J Korean Pediatr Soc 1984;27:395-400
  3. Selby DM, Stocker JT, Waclawiw MA, Hitchcock CL, Ishak KG. Infantile hemangioendothelioma of the liver. Hepatology 1994;20:39-45
  4. Dehner LP, Ishak KG. Vascular tumors of the liver in infants and children : a study of 30 cases and review of the literature. Arch Pathol 1971;92:101-11
  5. Jo HJ, Yun KJ, Lee JK, Lee JS, Moon HB. Infantile hemangioendothelioma of the liver. Korean J Pathol 1997;31:586-8
  6. Lunetta P, Karikoski R, Penttila A, Sajantila A. Sudden death associated with a multifocal type II hemangioendothelioma of the liver in a 3 month old infant. Am J Forensic Med Pathol 2004;25:56-9 https://doi.org/10.1097/01.paf.0000113864.15102.42
  7. Prokurat A, Kluge P, Chrupek M, Kosciesza A. Hemangioma of the liver in children : proliferating vascular tumor or congenital vascular malformation? Med Pediatr Oncol 2002;39:524-9 https://doi.org/10.1002/mpo.10179
  8. Szymik-Kantorowicz S, Partyka L, Dembinska-Kiec A, Zdzienicka A. Vascular endothelial growth factor in monitoring therapy of hepatic haemangioendothelioma. Med Pediatr Oncol. 2003;40:196-7 https://doi.org/10.1002/mpo.10128
  9. Daller JA, Bueno J, Gutierrez J, Dvorchik I, Towbin RB, Dickman PS, et al. Hepatic hemangioendothelioma : clinical experience and management strategy. J Pediatr Surg 1999; 34:98-106 https://doi.org/10.1016/S0022-3468(99)90237-3
  10. Zenge JP, Fenton L, Lovell MA, Grover TR. Case report : infantile hemangioendothelioma. Curr Opin Pediatr 2002;14: 99-102 https://doi.org/10.1097/00008480-200202000-00018
  11. Touloukian RJ. Hepatic hemangioendothelioma during infancy : pathology, diagnosis and treatment with prednisone. Pediatrics 1970;45:71-6
  12. Kasabach HH, Merritt KK. Capillary hemangioma with extensive purpura : report of a case. Am J Dis Child 1940;59: 1063-70
  13. Nguyen L, Shandling B, Ein S, Stephens C. Hepatic hemangioma in childhood : medical management or surgical management? J Pediatr Surg 1982;17:576-9 https://doi.org/10.1016/S0022-3468(82)80113-9
  14. Stocker JT. Hepatic tumors in children. Clin Liver Dis 2001;5:259-81 https://doi.org/10.1016/S1089-3261(05)70163-X
  15. Goldberg SJ, Fonkalsrud E. Successful treatment of hepatic hemangioma with corticosteroids. JAMA 1969;208:2473-4 https://doi.org/10.1001/jama.208.13.2473
  16. Park EA, Seo JW, Lee SW, Choi HY, Lee SJ. Infantile hemangioendothelioma treated with high dose methylprednisolone pulse therapy. J Korea Med Sci 2001;16:127-9
  17. Shannon K, Buchanan GR, Votteler TP. Multiple hepatic hemangiomas : failure of corticosteroid therapy and successful hepatic artery ligation. Am J Dis Child 1982;136: 275-6
  18. DeLorimier AA, Simpson EB, Baum RS, Carlsson E. Hepatic artery ligation for hepatic hemangiomatosis. N Eng J Med 1967;277:333-7 https://doi.org/10.1056/NEJM196708172770703
  19. Han SJ, Cho SS, Lee GH, Im HJ, Kim SH, Kim GH, et al. Two cases of infantile hemangioendothelioma of the liver in neonates. J Korean Pediatr Soc 2001;44:1469-74