A giant solitary fibrous tumour of the liver: a case report.

BACKGROUND: Solitary fibrous tumour of the liver is a rare mesenchymal tumour, occurring usually in women and with various symptomatology. The symptoms mostly result from pressure of the tumour mass on surrounding organs. Due to unknown biological behaviour and gradual increase of tumour volume, surgical resection is mostly the preferred treatment option. CASE: A 75-year-old woman with a history of endometrial cancer, presenting with an incidental finding of a liver mass, initially considered of infectious origin (either echinococcosis or cysticercosis). Further diagnostics did not clarify the aetiology, a surgical revision was rejected at the time. The subsequent follow-up was interrupted by the development of symptoms of gastrointestinal and renal obstruction, which led to a complete surgical removal of the tumour, sized 30 × 25 × 20 cm. A histopathological examination showed a CD34 and STAT6 positivity, leading to a diagnosis of a giant solitary fibrous tumour of the liver. The patient recovered well, without any signs of recurrence. CONCLUSION: The solitary fibrous tumour of the liver is a rare, often incidental finding. It is considered benign, but malignant growth was also reported. A gradual growth mostly results in pressure on other organs. A surgical resection is the treatment of choice. Transarterial embolization is another treatment possibility. Due to indeterminate malignant potential a regular follow-up is necessary, including tumour markers and imaging methods.

Hand-assisted laparoscopic liver resection using Habib's technique: early experience.

INTRODUCTION: Hand-assisted laparoscopic liver surgery, a newly developed technique based on an innovative concept, has proved useful and safe for a variety of less invasive hepatectomies. Radiofrequency-assisted hepatic resection has been reported to be safe, associated with minimal morbidity and mortality and decreased intraoperative blood loss and transfusion requirements. AIM: We describe how we perform hand-assisted laparoscopic radiofrequency-assisted hepatic resection using a bipolar radiofrequency device. RESULTS: The use of the hand port has allowed the surgeon to use his hand in direct liver manipulation, mobilization, and retraction. It was also useful for tactile tumour localization. Radiofrequency-assisted hepatic parenchymal transection was performed on 15 patients using a bipolar device (Habib 4X) with minimal blood loss (74 ml), and very decent operative and resection times (92 min, 33 min respectively). CONCLUSIONS: This combined procedure offers a safe, effective and rapid liver resection technique. This might encourage surgeons to perform a minimally invasive approach for liver resection more frequently.