Reprints Available Directly from the Publisher Photocopying Permitted by License Only (c) 2000 Opa (overseas Publishers Association) N.v. Syndrome" Is the Appropriate Treatment Enucleation or Liver Transplantation?

We present a case of giant cavernous hemangioma of the liver with disseminated intravascular coagulo-pathy (Kasabach-Merritt syndrome) which was cured by enucleation. The 51 year old woman presented with increased abdominal girth and easy bruisability. Workup elsewhere revealed a massive hepatic hemangioma and she was started on radiation therapy to the lesion and offered an orthotopic liver transplant. After careful preoperative preparation , we felt that resection was possible and she underwent a successful enucleation. The operation and postoperative course were complicated by bleeding but she recovered and remains well in followup after 6 months. All coagulation parameters have returned to normal. Enucleation should be considered the treatment of choice for hepatic hemangiomas, including those presenting with Kasabach-Merritt syndrome. The benefits of en-ucleation as compared to liver transplantation for these lesions are discussed.