外垂性肝血管瘤的超音波檢查：病例報告

Ultrasound Detection of Pedunculated Hepatic Hermangioma: A Case Report

35歲的少婦因輕度食慾不振、暈眩與左側腰部酸痛，而接受檢查。上消化道內視鏡呈現胃底部粘膜下腫瘤（submucosal tumor），腹部超音波檢查懷疑胃平滑肌瘤（gastric leiomyoma）。進一步的電腦斷層和血管攝影檢查，發現是左葉肝臟外垂的多洞性血管瘤（cavernous hemangioma）。經手術切除後，病理檢查証實為此－病變。本例報告提示：超音波檢查對於左側上腹部腫瘤的區別診斷，肝臟的外垂性血管瘤應為其中的一項。

A 35-year-old woman visited our OPD for having mild anorexia, dizziness and left flank sorepain for weeks, and received and upper gasterointestinal fiberoen-doscopy and an abdominal ultrasonography. The former revealed a submucosal tumor at upper gastric body and fundus on the posterior wall, and the latter demonstrated a huge well-defined solid mass of heterogeneous echogenicity with centrally hyperechoic change, in the left upper quadrant of the abdomen just between the stomach, the spleen and the pancreatic tail. Subsequently, an x-ray computed tomography and a celiac/selective hepatic arterial angiography were done, which resulted in a diagnosis of pedunculated hepatic cavernous hemangioma, that was proved pathologically as a cavernous hemangioma with central fibrosis at surgery. With the experience of such a case, we suggested that a pedunculated liver hemangioma should be also considered in differential diagnosis of abdominal tumor in the left upper quadrant.