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Volume 77 - 2014 - Fasc.3 - Reviews

Primary hepatic vascular tumours. A clinicopathologic study of 10 cases

Background : Primary hepatic vascular neoplasms constitute a heterogeneous group of neoplasms with characteristic histology and variable tumour biology. Aim : To provide an updated overview on clinicopathological features, treatment and outcome of primary hepatic vascular tu- mours. Patients and methods : In our retrospective study, we reviewed 10 cases of primary hepatic vascular tumours that were diagnosed at the pathology department of Mongi Slim hospital over a thir- teen-year period (2000-2012). Relevant clinical information and microscopic slides were available in all cases and were retrospec- tively reviewed. Results : Our study group included 4 men and 6 women (sex ra- tio M/F = 0,66) aged between 23 and 78 years (mean = 55,5 years). Based on imaging studies, preoperative diagnosis of hemangioma was accurately made in only three cases. Three cases were mis- diagnosed preoperatively as having hydatid cyst and four cases of hemangiomas were misdiagnosed preoperatively as liver metasta- ses. All our patients underwent surgical resection of the tumour. Histopathological examination of the surgical specimen established the diagnosis of angiosarcoma in one case, cavernous hemangioma in 8 cases and sclerosing hemangioma in one case. Conclusion : Hepatic tumours are increasingly detected inciden- tally due to widespread use of modern abdominal imaging tech- niques. Therefore, reliable noninvasive characterization and dif- ferentiation of such liver tumours is of major importance for clinical practice. Definitive diagnosis is based on histopathologic examination. (Acta gastroenterol. belg., 2014, 77, 347-352).


Four patients with Amanita Phalloides poisoning

Mushroom poisoning by Amanita phalloides is a rare but poten- tially fatal disease. The initial symptoms of nausea, vomiting, ab- dominal pain and diarrhea, which are typical for the intoxication, can be interpreted as a common gastro-enteritis. The intoxication can progress to acute liver and renal failure and eventually death. Recognizing the clinical syndrome is extremely important. In this case report, 4 patients with amatoxin intoxication who showed the typical clinical syndrome are described. The current therapy of amatoxin intoxication is based on small case series, and no ran- domised controlled trials are available. The therapy of amatoxin intoxication consists of supportive care and medical therapy with silibinin and N-acetylcysteine. Patients who develop acute liver fail- ure should be considered for liver transplantation. (Acta gastro- enterol. belg., 2014, 77, 353-356).