Benign and Solid Tumors of the Liver: Relationship to Sex, Age, Size of Tumors, and Outcome

American Surgeon - Tập 67 Số 2 - Trang 173-178 - 2001
K. Rajender Reddy1, Seth Kligerman1, Joé U. Levi2, Alan S. Livingstone2, Enrique Molina1, Dido Franceschi2, Salvatore Badalamenti1, Lennox J. Jeffers1, Andreas G. Tzakis2, Eugene R. Schiff1
1Departments of Medicine, Center for Liver Diseases, Division of Hepatology, University of Miami School of Medicine and Veterans Administration Medical Center, Miami, Florida
2Departments of Surgery, Center for Liver Diseases, Division of Hepatology, University of Miami School of Medicine and Veterans Administration Medical Center, Miami, Florida

Tóm tắt

From 1983 through 1997, our center diagnosed 130 cases of benign neoplasms: 27 with focal nodular hyperplasia (FNH), 25 with hepatic adenoma, 71 with cavernous hemangioma, and seven with mixed tumors of different diagnoses. Most often these lesions were seen in females [female-to-male ratio (f/m): 5.5/1]. Hepatic adenomas and mixed tumors were seen exclusively in females and FNH predominantly in females (f/m: 26/1). Hemangiomas, however, were not uncommon in men (f/m: 52/19) relative to the other tumors ( P < 0.001). Furthermore patients with hemangioma were older (mean age: 49 years) whereas patients with hepatic adenoma, FNH, and mixed tumors were often younger (mean age: 33, 35, and 44 years respectively; P < 0.004). Oral contraceptive steroid use was related by 21 of 25 patients (84%) with hepatic adenoma, 22 of 26 (85%) females with FNH, five of seven (71%) females with mixed tumors, and 10 of 52 (19%) patients with hemangioma. Ninety-five of the 130 patients (73%) had one or more symptoms. There was no statistically significant correlation between symptoms and the size of the lesion, the final diagnosis, and whether there were solitary or multiple masses. Three of 25 (12%) with hepatic adenoma presented with rupture, and one of 27 (4%) with FNH had such a consequence. None of the hemangiomas presented with rupture or progressed to such a state. One patient with hepatic adenoma (4%) had a focus of malignancy. Surgical removal of benign tumors was performed in 82 of 130 patients (63%), and there was one operative mortality (1.2%) in a patient who had a caudate lobe FNH. The types of surgical procedures included segmentectomy (62%), lobectomy (34%), and trisegmentectomy (4%). In two of 84 patients who had undergone laparotomy resection was not technically possible. Resection is recommended in all cases of hepatic adenoma because of fear of rupture or associated focus of malignancy. FNH was not observed to undergo a malignant transformation and will rarely rupture. Surgery is only recommended for symptomatic hemangioma, and size of the lesion is not a criterion for excision.

Từ khóa


Tài liệu tham khảo

10.1055/s-2007-1007370

Shortell CK, 1991, Surg Gynecol Obstet, 173, 426

10.1016/0016-5085(83)90202-0

10.1016/S0140-6736(73)92594-4

10.1016/S0016-5085(19)32205-X

10.1001/archinte.1977.03630150057016

10.1016/0016-5085(89)91429-7

10.7326/0003-4819-105-4-547

10.7326/0003-4819-110-6-489

10.7326/0003-4819-86-2-180

10.1016/0002-9610(83)90165-4

10.1007/BF00316974

Yamamoto T, 1991, Am J Gastroenterol, 86, 1645

10.1001/archsurg.1984.01390230078019

Creasy GW, 1985, Obstet Gyncol, 66, 10S

Morley JE, 1974, S Afr Med J, 1, 695

Kuo PC, 1994, J Am Coll Surg, 178, 49

10.1097/00000658-198810000-00004

10.7326/0003-4819-83-3-301

Becker YT, 1995, Am Surg, 61, 210

10.1097/00003072-199709000-00001

10.1148/radiology.198.3.8628888

Kent, 1978, Obstet Gynecol, 51, 148

Wanless IR, 1986, Arch Pathol Lab Med, 110, 331

10.1016/0002-9610(81)90005-2

10.1002/bjs.1800830812

Thông tin
Thông tin xuất bản

American Surgeon

Tập 67 Số 2

173-178

Thông tin tác giả