Abstract
Chronic expanding hematoma (CEH) is defined as a hematoma that grows slowly over a month or longer. CEH with a primary hepatic origin is extremely rare. An 85-year-old man presented with general malaise and low-grade fever. His medical history included hypertension and postoperative appendicitis, and he was taking oral aspirin. Computed tomography showed a 7-cm mass in liver S7 with calcification at the margin. On contrast-enhanced magnetic resonance imaging, the inside of the mass showed heterogeneous hyperintensity on T1-weighted images, mainly low intensity on T2-weighted images, and mild hyperintensity in some areas. Under the preoperative diagnosis of suspected CEH, hemorrhagic cyst, or hepatocellular carcinoma, S7 partial liver resection and cholecystectomy were performed. Histopathological findings showed that the mass was continuous with the liver and protruded extrahepatically, and was covered with a hard fibrous capsule. The capsule contained hematomas ranging from obsolete to relatively fresh, with no neoplastic lesions. He was diagnosed with CEH in the liver. This subcapsular hepatic hematoma was pathologically shown to be a CEH. Complete surgical resection was effective in treating this CEH in the liver.
Similar content being viewed by others
References
Reid JD, Kommareddi S, Lankerani M, et al. Chronic expanding hematomas. A clinicopathologic entity. JAMA. 1980;244:2441–2.
Ono Y, Kariya S, Nakatani M, et al. Subcapsular hepatic hematoma: a case of chronic expanding hematoma of the liver. BMC Gastroenterol. 2021;21:241.
Taniguchi A, Nishiyama T, Kozai J, et al. Chronic expanding hematoma in the liver: a case report. Surg Case Rep. 2022;8:209.
Sevy B, Stanley DP, Doctry NE, et al. Chronic expanding hematoma of the calf. Jt Bone Spine. 2015;82:131–2.
Kuwata T, Uramoto H, Tanaka F. Preoperative embolization followed by palliative therapy for patients unable to undergo the complete removal of a chronic expanding hematoma—a case report. Asian J Surg. 2013;36:40–2.
Okada K, Sugiyama T, Kato H, et al. Chronic expanding hematoma mimicking soft tissue neoplasm. J Clin Oncol. 2001;19:2971–2.
Labadie EL, Glover D. Physiopathogenesis of subdural hematomas. Part 1: histological and biochemical comparisons of subcutaneous hematoma in rats with subdural hematoma in man. J Neurosurg. 1976;45:382–92.
Sakurai J, Akaki S, Yonezawa M, et al. Intrapelvic chronic expanding hematoma: magnetic resonance imaging findings with pathological correlation. Magn Reson Med Sci. 2010;9:81–4.
Kwon Y, Koh W, Kim T, et al. Chronic expanding hematoma of the thorax. Yonsei Med J. 2007;48:337–40.
Nishida Y, Kobayashi E, Kubota D, et al. Chronic expanding hematoma with a significantly high fluorodeoxyglucose uptake on 18F-fluorodeoxyglucose positron emission tomography, mimicking a malignant soft tissue tumor: a case report. J Med Case Rep. 2014;8:349.
Burgert-Lon C, Riddle N, Lackman R, et al. Angiosarcoma arising in chronic expanding hematoma: five cases of an underrecognized association. Am J Surg Pathol. 2015;39:1540–7.
Muramatsu T, Shimamura M, Furuichi M, et al. Treatment strategies for chronic expanding hematomas of the thorax. Surg Today. 2011;41:1207–10.
Lee HN, Cho SG, Lee WH. Interventional management of subcapsular hepatic hematoma with hepatic compartment syndrome after laparoscopic adrenalectomy. Cardiovasc Intervent Radiol. 2019;42:625–8.
Aldemir M, Baç B, Taçyildiz I, et al. Spontaneous liver hematoma and a hepatic rupture in HELLP syndrome: report of two cases. Surg Today. 2002;32:450–3.
Terayama N, Matsui O, Ueda F, et al. CO2 demonstration of multiple extravasations into a subcapsular hematoma of the liver. Cardiovasc Intervent Radiol. 2004;27:278–81.
Ibukuro K, Mori M, Akita K. The hepatic capsular arteries: imaging features and clinical significance. Abdom Radiol (NY). 2019;44:2729–39.
Acknowledgements
We thank Kelly Zammit, BVSc, from Edanz (https://jp.edanz.com/ac) for editing a draft of this manuscript.
Funding
Not applicable.
Author information
Authors and Affiliations
Contributions
TS, KS, YM, TT, and EO were involved in the surgery and treatment of the patient and prepared the manuscript and the literature search. YT gave the final approval of the version to be published. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no competing interests.
Consent for publication
Written informed consent was obtained from the patient for the publication of this case report.
Human/animal rights
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Shimagaki, T., Sugimachi, K., Mano, Y. et al. Chronic expanding hematoma of the liver: a case report and review of the literature. Clin J Gastroenterol 17, 93–99 (2024). https://doi.org/10.1007/s12328-023-01864-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12328-023-01864-0