Clinical and Translational Radiation Oncology (Mar 2021)

Proton beam therapy for a giant hepatic hemangioma: A case report and literature review

  • Shosei Shimizu,
  • Masashi Mizumoto,
  • Toshiyuki Okumura,
  • Yinuo Li,
  • Keiichirou Baba,
  • Motohiro Murakami,
  • Toshiki Ishida,
  • Masatoshi Nakamura,
  • Yuichi Hiroshima,
  • Takashi Iizumi,
  • Takashi Saito,
  • Haruko Numajiri,
  • Kei Nakai,
  • Masaharu Hata,
  • Hideyuki Sakurai

Journal volume & issue
Vol. 27
pp. 152 – 156

Abstract

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Background: Hepatic hemangiomas are benign tumors with a favorable prognosis, but giant hepatic hemangiomas can cause abdominal symptoms and are indicated for treatment. Most cases are treated with surgery, but radiotherapy has also been used. However, to date, there have been no reports of proton beam therapy for a hepatic hemangioma. Case presentation: A 46-year-old woman had a tumor of 80 × 80 mm in the left medial lobe of the liver, which was diagnosed as a giant hemangioma based on the contrast pattern. Therapy was required for a giant hepatic hemangioma with symptoms, but the patient refused blood transfusion due to religious reasons, which made surgical resection difficult. Therefore, she was referred to our hospital for proton beam therapy. At her first visit, liver function was Child-Pugh A (5 points) and there was no elevation of tumor markers. Proton beam therapy of 28.6 Gy (RBE) given in 13 fractions was performed without interruption. The only observed acute radiation toxicity was Grade 1 dermatitis. One year after proton beam therapy, the hemangioma had significantly decreased, and a complete response has been maintained for 15 years based on ultrasound and MRI. Conclusion: This case is the first reported use of proton beam therapy for a hepatic hemangioma. The outcome suggests that this treatment may be effective for a giant liver hemangioma.

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