[Hepatic peliosis--a rare liver tumor and challenge for diagnostic investigation plus therapy]. / Peliosis hepatis: seltene Differenzialdiagnose der Leberraumforderung und interdisziplinäre Herausforderung für Diagnostik und Therapie.

HISTORY AND ADMISSION FINDINGS: A 42-year-old woman presented at our hospital, because of a non-specific hepatic tumor. She complained of dull pain in the right upper abdomen. Physical examination did not reveal any pathology, especially there was no evidence of an infection. Abuse of drugs, alcohol or anticontraceptives was also denied. INVESTIGATIONS UND THERAPY: Even though fine needle biopsy and extensive radiological examination were performed a malignant nature of the liver tumor could not be excluded. Therefore a hemihepatectomy was performed. TREATMENT AND COURSE: The postoperative course was normal and the patient was released from hospital after 11 days. The histological examination revealed an incidental finding of an extended peliosis hepatis. CONCLUSION: Peliosis hepatis is a rare disease of the liver, histologically characterized by blood filled cavities. The clinical picture of this disease is mostly asymptomatic, but it may also lead to liver failure, portal hypertention and massive intrahepatic bleeding. The preoperative differentiation is an interdisciplinary challenge, especially in terms of radiological examination (chemical shift MRI; liver specific radiocontrast). If the distinction to a malignancy cannot be excluded operative resection is indicated.