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<p>Although observation is the standard management strategy for hepatic hemangiomas (HHs), surgical intervention may be indicated in cases of progressive enlargement, lesions &gt; 50&#xa0;mm, those causing compressive symptoms, or those associated with Kasabach–Merritt syndrome. Here, we report the case of a 51-year-old woman with a giant HH occupying almost the entire liver with a volume of 6572.5&#xa0;mL. The patient presented with severe compressive symptoms and coagulopathy; however, surgical resection was infeasible. Because she did not develop liver failure, transplantation was not indicated, and no effective treatment options were available. Sirolimus, a mammalian target of rapamycin inhibitor, has been used to treat intractable lymphatic disorders and congenital vascular malformations; however, there have been no previous reports on its use in adult giant HHs. Moreover, sirolimus was administered, which resulted in remarkable tumor shrinkage. This suggests that sirolimus may be a valuable therapeutic option for adult patients with giant HHs in whom conventional treatments are not applicable.</p>

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Giant hepatic hemangioma in a Japanese adult patient reduced by sirolimus therapy

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  • 发表日期：

    2025年8月1日

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  • Mio Tsuruoka,
  • Masashi Ninomiya,
  • Jun Inoue,
  • Kosuke Sato,
  • Keishi Ouchi,
  • Kengo Watanabe,
  • Kotaro Doi,
  • Tomoya Sasazaki,
  • Atsushi Masamune

摘要

Although observation is the standard management strategy for hepatic hemangiomas (HHs), surgical intervention may be indicated in cases of progressive enlargement, lesions > 50 mm, those causing compressive symptoms, or those associated with Kasabach–Merritt syndrome. Here, we report the case of a 51-year-old woman with a giant HH occupying almost the entire liver with a volume of 6572.5 mL. The patient presented with severe compressive symptoms and coagulopathy; however, surgical resection was infeasible. Because she did not develop liver failure, transplantation was not indicated, and no effective treatment options were available. Sirolimus, a mammalian target of rapamycin inhibitor, has been used to treat intractable lymphatic disorders and congenital vascular malformations; however, there have been no previous reports on its use in adult giant HHs. Moreover, sirolimus was administered, which resulted in remarkable tumor shrinkage. This suggests that sirolimus may be a valuable therapeutic option for adult patients with giant HHs in whom conventional treatments are not applicable.