e295 Hepatic resection for giant haemangioma Hepatic resection for giant haemangioma in a patient with a contemporaneous adult polycystic liver disease G.B. Levi Sandri, Q. Lai, F. Melandro, N. Guglielmo, M. Garofalo, V. Morabito, C. Cirelli 2 , P. Lucatelli 2 , M. Di Laudo 1 , M. Rossi 1 , P.B. Berloco 1 1 Department of General Surgery and Organ Transplantation, University of Rome “Sapienza”, Rome, Italy; 2 Department of Radiolo- gical Sciences, University of Rome “Sapienza”, Rome, Italy Case report Clin Ter 2012; 163 (5):295-296 Correspondence: Dott. Giovanni Battista Levi Sandri, Department of General Surgery and Organ Transplantation, ‘Sapienza’ University of Rome, Umberto I Policlinic of Rome, Viale del Policlinico 155, 00161, Rome, Italy. E-mail: gblevisandri@gmail.com Copyright © Società Editrice Universo (SEU) Introduction Adult polycystic liver disease (APCLD) is a genetically related condition characterized by multiple variably-sized cysts lined by cuboidal epithelium involving the liver: (1) the first description of this pathology was made by Bristo- we in 1856 (2). The effective prevalence of this disease is unknown: typically, APCLD is asymptomatic and it is dia- gnosed incidentally. (3) Liver disease is often obscured by accompanying adult polycystic kidney disease (4). Rarely, Abstract Hepatic resection for giant haemangioma in a patient with a contemporaneous adult polycystic liver disease. According to Gigot classification, and to the characteristics of haemangioma surgery in these patients can be considered safe. We report the case of a 55 year- old man affected by an adult polycystic liver disease (PCLD) and a contemporaneous symptomatic haemangioma of the III segment. At the preoperative imaging scans, APCLD was classified in a type II grading according to Gigot classification. The patient underwent surgery: a wedge resection of the III segment with the exportation of the haemangioma and a fenestration of a large cyst placed in the VIII segment were performed. Post-operative course was regular and the patient was discharged uneventfully in post-operative 9th day, with a total regress of the initial symptoms. APCLD and haemangioma are two benign conditions that do not require surgery except if they cause important symptoms, such as pain. The good clinical conditions of the patient, the moderate gravity of the APCLD and the particular exofitic localisation of the cavernous haemangioma gave us the possibility to make a safe surgery for the patient. To the best of our knowledge, this is the first case reported in literature in which a liver resection for haemangioma in patient with APCLD was performed. In conclusion, liver resection for haemangioma is not contraindicated, mainly if it is symptomatic, even in the contemporaneous presence of an APCLD. Clin Ter 2012; 163(5):295-296 Key words: benign disease, haemangioma, hepatectomy, liver function, polycystic liver disease APCLD evolves in a symptomatic hepatomegaly and could require a surgical treatment, even liver transplantation (5). Liver haemangioma is a well-know benign liver tumour: (6) it is the most common tumour of the liver, being reported in 1-7% of world population (7). Haemangiomas with a diameter superior to 4 cm are called giant haemangiomas, commonly resulting as symptomatic abdominal masses: in these well selected cases, surgery represents the therapy of choice (8). Case report We report the case of a 55 year-old Caucasian man affec- ted by APCLD, admitted to our centre for abdominal pain. The patient presented a conserved hepatic function, tumour and viral markers resulted negative. The patient had no other pathology or risk factor for surgery. Computer tomography and magnetic resonance scans showed a 15-cm haemangio- ma involving the III hepatic segment (Fig. 1). Basing on pre-operative imaging, APCLD was classified in a type II grading, according to Gigot classification, (9) showing a diffuse involvement of liver parenchyma by me- dium sized cysts with remaining large areas of non-cystic pa- renchyma. The patient underwent surgery: a wedge resection of the III segment with the exportation of the haemangioma and a fenestration of a large cyst placed in the VIII segment were performed (Fig. 2). A 18x14x8 cm cavernous haemangioma was described at pathology (Fig. 3). Post-operative course was regular and the patient was discharged uneventfully in post-operative 9th day, with a total regression of the initial symptoms. Currently, after 2 years of follow-up, the patient is alive with an optimal liver function. Discussion APCLD and haemangioma are two benign conditions that do not require surgery except if they cause important