Hémangiome hépatique géant de découverte tomodensitométrique

We report the case of a 48-year old woman who had had progressive increase in abdominal volume, intermittent abdominal pain without intestinal transit disorders associated with altered general condition since 1 year and a half. Clinical examination showed voluminous painless abdomino-pelvic mass, mobile and hard to palpation. Initial laboratory testing showed microcytic hypochromic anaemia of 9.6 g/dL with no external bleeding, anicteric cholestasis with alkaline phosphatases 151 IU/L and GGT 71 IU/L. The remaining elements were normal. This clinicalbiological assessment was completed using abdominal ultrasound which showed a voluminous poorly delineated lesion with heterogeneous hypoechoic echostructure, in intimate contact with the liver, without doppler-specific vascularization. Complementary abdominal-pelvic CT scan showed voluminous mass in the right liver extending downward into the pelvic region measuring approximately 48x30x27cm in the different planes. This mass was spontaneously hypodense and showed an spotted uptake after injection of contrast media providing evidence of an angiomatous lesion. Moreover, the mass included the portal trunk and left intrahepatic venous branches. The other branches of the subhepatic veins and the IVC were rolled. The diagnosis of complex giant hemangioma remodeled with areas of necrosis and thrombosis was retained. The patient received analgesic drug therapy, in the absence of a therapeutic outcome.