ABSTRACT
A 51-year-old woman presented to the outpatient clinic with appetite loss and abdominal pain that had persisted for 1 month. Computed tomography (CT) showed a bulky tumor in the right liver, with hepatosplenomegaly and lymphadenopathy in several para-aortic lymph nodes. The diagnosis of diffuse large B-cell lymphoma was confirmed by a biopsy of a submucosal tumor in the stomach. Bone marrow invasion by lymphoma cells was observed. On day5 after a rituximab, cyclophosphamide, vincristine, and prednisone (R-CVP) regimen was initiated, epigastralgia and right hypochondralgia were noted. On day6, severe anemia (hemoglobin level, 4.2 g/dl) developed. Repeat CT showed a low-density area surrounding the hepatic tumor caused by tumor lysis, and hepatic tumor rupture was suspected. Transfusion was performed, and no signs of recurrence of bleeding were noted after the procedure. On day21, angiography of the hepatic artery showed no signs of bleeding. After two cycles of R-CVP therapy and eight cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone therapy, partial remission was achieved. In this report, we present a rare case of patient survival following hepatic tumor rupture associated with hepatic lymphoma after treatment.
Subject(s)
Liver Neoplasms , Lymphoma, Large B-Cell, Diffuse , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cyclophosphamide/therapeutic use , Doxorubicin/therapeutic use , Female , Humans , Liver Neoplasms/complications , Liver Neoplasms/drug therapy , Lymphoma, Large B-Cell, Diffuse/diagnosis , Lymphoma, Large B-Cell, Diffuse/drug therapy , Middle Aged , Prednisone/therapeutic use , Rituximab/therapeutic use , Vincristine/therapeutic useABSTRACT
We report a case of a fusiform aneurysm in the P2 segment of the posterior cerebral artery treated with stent-assisted coil embolization. A 44-year-old woman presented with an unruptured fusiform aneurysm in the left posterior cerebral artery. Stent-assisted coil embolization was performed using a "down-the-barrel" view to preserve the parent artery. The postoperative course was uneventful, and MRI showed no evidence of cerebral infarct. The patient was discharged 12 days after surgery, with no neurological deficit. Complete occlusion of the aneurysm and patency of the parent artery were observed on MR angiography at a 3-months follow up. Stent-assisted coil embolization can therefore be an effective alternative to parent artery occlusion in P2 segment fusiform aneurysms of the posterior cerebral artery.