A case of giant hemangioma of the liver with abdominal wall abscess

症例は31歳女性．2年前より肝血管腫と診断され，経過観察されていた．腹痛，発熱が頻回に出現し，精査加療目的に当院へ入院となった．CTでは右葉全域を占める，40 cm大の巨大な血管腫を認めた．この腫瘍に連続して右側腹部に10 cm大の辺縁が造影される嚢胞状構造が認められ，腹壁膿瘍を併発していると診断し，手術を施行した．腫瘍が巨大であったため，前方アプローチで肝右葉切除を行った．腫瘍右側に連続して腹壁に膿瘍を形成しており，内腔を十分に洗浄した後開放のままとした．切除した腫瘍は，3170 g，赤褐色，弾性軟で，組織学的には細胞異型はなく，良性肝海綿状血管腫と診断した．膿瘍の原因菌はFusobacterium necrophorumであった．巨大肝血管腫に膿瘍を合併した非常にまれな1例を経験したので報告する．

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