A case of exophytic hepatic hemangioma mimicking adrenal tumor

Abstract

62歳男.原発性副甲状腺機能亢進症及びCTにて偶然発見された腹部腫瘤の精査加療の為当科受診, 超音波断層法, CT, MRIにて4.0×2.5cmの内部不均一な腫瘍を肝と右腎の間に認めた.超音波カラードプラ法では明かな血流を認めず, 副腎機能は正常であった.原発性副甲状腺機能亢進症及び内分泌非活性型副腎腫瘍の診断にて, まず副甲状腺腫瘍摘除術を施行した.その3週間後腹腔鏡的右副腎摘除術を施行した所, 腫瘍は肝より発生しており, 開放的肝部分切除術を施行した.腫瘍は病理組織にて肝海綿状血管腫であった

A rare case of exophytic hepatic hemangioma preoperatively diagnosed as a non-functioning adrenal tumor is reported. A 62-year-old man was admitted for treatment of primary hyper-parathyroidism and an incidental adrenal tumor. A 4.0 x 2.5 cm heterogeneous tumor located between the liver and the right kidney was detected by abdominal ultrasonography, computed tomography and magnetic resonance imaging. Color doppler images revealed no apparent blood flow. Since the tumor seemed to have originated from the liver under laparoscopy, an open partial hepatectomy was performed. Histopathological examination revealed cavernous hemangioma of the liver. When diagnosing non-functioning right adrenal tumor, it may be necessary to carefully rule out an exophytic liver tumor.