Case Report: Surgical management of giant hepatic cavernous haemangioma with Kasabach-Merritt syndrome in an adult.

A 25-year-old woman presented with a progressively enlarging abdominal mass and severe coagulopathy (fibrinogen 0.6 g/L). Imaging revealed a giant, predominantly calcified hepatic lesion lacking typical nodular enhancement, raising suspicion for hamartoma or cystadenoma. Despite aggressive fibrinogen replacement, coagulopathy persisted. Multidisciplinary team discussion confirmed Kasabach-Merritt syndrome secondary to giant hepatic haemangioma. Anatomical left lateral sectionectomy was performed successfully. Histopathology confirmed cavernous haemangioma with thrombosis, infarction, and calcification. Coagulation parameters normalized immediately postoperatively. This case highlights the diagnostic pitfall of non-enhancing giant hepatic haemangioma and underscores the curative role of early surgical resection in adult Kasabach-Merritt syndrome.