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| {{Infobox_Disease |
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| Name = {{PAGENAME}} |
| | {{Hepatic hemangioma}} |
| Image = Heptatic hemangioma 005.jpg|
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| Caption = Heptatic hemangioma. <br> [http://www.radswiki.net Image courtesy of RadsWiki]|
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| '''For patient information, click [[Hepatic hemangioma (patient information)|here]]''' | | '''For patient information, click [[Hepatocellular hemangioma (patient information)|here]]''' |
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| {{CMG}}; {{AE}} [[User:zorkun|Cafer Zorkun]] M.D., PhD. | | {{CMG}}; {{AE}} [[User:zorkun|Cafer Zorkun]] M.D., PhD., {{NM}} |
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| ==Overview==
| | {{SK}} Liver hemangioma; Hemangioma of the liver; Cavernous hepatic hemangioma; Typical hepatic hemangioma; Atypical hepatic hemangioma; Giant hepatic hemangioma; Flash filling hepatic hemangioma; Slow fill hepatic hemangioma; Calcified hepatic hemangioma; Hyalinised hepatic hemangioma; Sclerosed hepatic hemangioma; Pedunculated hepatic hemangioma; Cystic hepatic hemangioma; Hepatocyte hemangioma; Hepatocellular hemangioma |
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| '''Hepatic hemangioma''' is the most common primary liver tumor.
| | ==[[Hepatic hemangioma overview|Overview]]== |
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| ==Pathophysiology== | | ==[[Hepatic hemangioma historical perspective|Historical perspective]]== |
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| * Arise from the endothelial cells that line the blood vessels and consists of multiple, large vascular channels lined by a single layer of endothelial cells and supported by collagenous walls.
| | ==[[Hepatic hemangioma classification|Classification]]== |
| * They may be associated with [[focal nodular hyperplasia]].
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| * May be associated with [[Kasabach-Merritt syndrome]]: [[Hemolytic anemia]] and consumptive coagulopathy
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| ==Epidemiology and Demographics== | | ==[[Hepatic hemangioma pathophysiology|Pathophysiology]]== |
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| The incidence ranges from 0.4-20% of the population.
| | ==[[Hepatic hemangioma causes|Causes]]== |
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| ===Gender=== | | ==[[Hepatic hemangioma differential diagnosis|Differentiating Hepatic Hemangioma from other Diseases]]== |
| Females predominate over males 5:1
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| ==Diagnosis== | | ==[[Hepatic hemangioma epidemiology and demographics|Epidemiology and Demographics]]== |
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| They are frequently asymptomatic and incidentally discovered at imaging, surgery, or autopsy.
| | ==[[Hepatic hemangioma risk factors|Risk Factors]]== |
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| ===Ultrasonography=== | | ==[[Hepatic hemangioma screening|Screening]]== |
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| * Echogenic
| | ==[[Hepatic hemangioma natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| * Homogenous
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| ===Computed Tomography=== | | ==Diagnosis== |
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| * Noncontrast: Hypointense to liver
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| * Portal venous enhancement: Peripheral nodular enhancement
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| * Delayed enhancement: Lesion fills in the contrast
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| ===MRI===
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| * T2 hyperintense
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| * Portal venous enhancement: Peripheral nodular enhancement
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| * Delayed enhancement: Lesion fills in the contrast
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| ===Scintigraphy===
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| * Tc99-labeled red blood cells show decreased activity on early dynamic images and increased activity on delayed images (i.e. 1-2 hours).
| | [[Hepatic hemangioma history and symptoms|History and Symptoms]] | [[Hepatic hemangioma physical examination|Physical Examination]] | [[Hepatic hemangioma laboratory findings|Laboratory Findings]] | [[Hepatic hemangioma CT|CT]] | [[Hepatic hemangioma MRI|MRI]] | [[Hepatic hemangioma echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Hepatic hemangioma other imaging findings|Other Imaging Findings]] | [[Hepatic hemangioma other diagnostic studies|Other Diagnostic Studies]] |
| * Only sensitive for larger lesions.
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| ==Diagnostic Findings== | | ==Treatment== |
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| [http://www.radswiki.net Images courtesy of RadsWiki] | | [[Hepatic hemangioma medical therapy|Medical Therapy]] | [[Hepatic hemangioma surgery|Surgery]] | [[Hepatic hemangioma prevention|Prevention]] | [[Hepatic hemangioma cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Hepatic hemangioma future or investigational therapies|Future or Investigational Therapies]] |
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| <gallery perRow="3">
| | ==Case Studies== |
| Image:Heptatic hemangioma 001.jpg|T2 FrFSE
| | [[Hepatic hemangioma case study one|Case #1]] |
| Image:Heptatic hemangioma 002.jpg|T1
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| Image:Heptatic hemangioma 003.jpg|T1 post Gad
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| Image:Heptatic hemangioma 004.jpg|T1 post Gad
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| Image:Heptatic hemangioma 005.jpg|T1 post Gad
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| Image:Heptatic hemangioma 006.jpg|T1 post Gad coronal
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| </gallery>
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| ==Related Chapters== | | ==Related Chapters== |
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| *[[Infantile hemangioendothelioma]] | | *[[Infantile hemangioendothelioma]] |
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| ==References & Additional Resources==
| | {{Gastroenterology}} |
| {{Refbegin|2}} | |
| *Moser C, Hany A, Spiegel R. [Familial giant hemangiomas of the liver. Study of a family and review of the literature]. Praxis (Bern 1994). Apr 1 1998;87(14):461-8.
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| *Takahashi T, Kuwao S, Katagiri H, et al. Multiple liver hemangiomas enlargement during long-term steroid therapy for myasthenia gravis. Dig Dis Sci. Jul 1998;43(7):1553-61.
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| *Giannitrapani L, Soresi M, La Spada E, et al. Sex hormones and risk of liver tumor. Ann N Y Acad Sci. Nov 2006;1089:228-36.
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| *Glinkova V, Shevah O, Boaz M, et al. Hepatic haemangiomas: possible association with female sex hormones. Gut. Sep 2004;53(9):1352-5.
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| *Spitzer D, Krainz R, Graf AH, et al. Pregnancy after ovarian stimulation and intrauterine insemination in a woman with cavernous macrohemangioma of the liver. A case report. J Reprod Med. Dec 1997;42(12):809-12.
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| *Dreyfus M, Baldauf JJ, Dadoun K, et al. Prenatal diagnosis of hepatic hemangioma. Fetal Diagn Ther. Jan-Feb 1996;11(1):57-60.
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| *Suzuki T, Tsuchiya N, Ito K. Multiple cavernous hemangiomas of the liver in patients with systemic lupus erythematosus. J Rheumatol. Apr 1997;24(4):810-1.
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| *Goodman Z. Benign tumors of the liver. In: Okuda K, Ishak KG. Neoplasms of the liver. Tokyo: Springer-Verlag; 1987:105-125.
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| *Mikami T, Hirata K, Oikawa I, et al. Hemobilia caused by a giant benign hemangioma of the liver: report of a case. Surg Today. 1998;28(9):948-52.
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| *Lee CW, Chung YH, Lee GC, et al. A case of giant hemangioma of the liver presenting with fever of unknown origin. J Korean Med Sci. Apr 1994;9(2):200-4.
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| *Pol B, Disdier P, Le Treut YP, et al. Inflammatory process complicating giant hemangioma of the liver: report of three cases. Liver Transpl Surg. May 1998;4(3):204-7.
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| *Huang SA, Tu HM, Harney JW, et al. Severe hypothyroidism caused by type 3 iodothyronine deiodinase in infantile hemangiomas. N Engl J Med. Jul 20 2000;343(3):185-9.
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| *Lorette G, Georgesco G, Sirinelli D, et al. [Cutaneous immature hemangioma and hepatic angioma: there is no frequent association]. Ann Dermatol Venereol. 1996;123(12):789-90.
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| *Brannigan M, Burns PN, Wilson SR. Blood flow patterns in focal liver lesions at microbubble-enhanced US. Radiographics. Jul-Aug 2004;24(4):921-35.
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| *Dietrich CF, Mertens JC, Braden B, et al. Contrast-enhanced ultrasound of histologically proven liver hemangiomas. Hepatology. May 2007;45(5):1139-45.
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| *von Herbay A, Vogt C, Willers R, et al. Real-time imaging with the sonographic contrast agent SonoVue: differentiation between benign and malignant hepatic lesions. J Ultrasound Med. Dec 2004;23(12):1557-68.
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| *Farges O, Daradkeh S, Bismuth H. Cavernous hemangiomas of the liver: are there any indications for resection?. World J Surg. Jan-Feb 1995;19(1):19-24.
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| *Obata S, Matsunaga N, Hayashi K, et al. Fluid-fluid levels in giant cavernous hemangioma of the liver: CT and MRI demonstration. Abdom Imaging. Nov-Dec 1998;23(6):600-2.
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| *Kinnard MF, Alavi A, Rubin RA, et al. Nuclear imaging of solid hepatic masses. Semin Roentgenol. Oct 1995;30(4):375-95.
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| *Krause T, Hauenstein K, Studier-Fischer B, et al. Improved evaluation of technetium-99m-red blood cell SPECT in hemangioma of the liver. J Nucl Med. Mar 1993;34(3):375-80.
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| *Tsai CC, Yen TC, Tzen KY. Pedunculated giant liver hemangioma mimicking a hypervascular gastric tumor on Tc-99m RBC SPECT. Clin Nucl Med. Feb 1999;24(2):132-3.
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| *De Franco A, Monteforte MG, Maresca G, et al. [Integrated diagnosis of liver angioma: comparison of Doppler color ultrasonography, computerized tomography, and magnetic resonance]. Radiol Med. Jan-Feb 1997;93(1-2):87-94.
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| *Heilo A, Stenwig AE. Liver hemangioma: US-guided 18-gauge core-needle biopsy. Radiology. Sep 1997;204(3):719-22.
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| *Bruix J, Sherman M, Llovet JM, et al. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver. J Hepatol. Sep 2001;35(3):421-30.
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| *Craig JR, Peters RL, Edmondson HA. Tumors of the Liver and Intrahepatic Bile Ducts, 2nd series, fascicle 26. Washington, DC. Armed Forces Institute of Pathology. 1989;191.
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| *Ishak KG, Markin RS. Liver. In: Damjanov I, Linder J, eds. Anderson's Pathology. 10th ed. Mosby: St. Louis, Mo; 1996:1834.
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| *Gibney RG, Hendin AP, Cooperberg PL. Sonographically detected hepatic hemangiomas: absence of change over time. AJR Am J Roentgenol. Nov 1987;149(5):953-7.
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| *Corigliano N, Mercantini P, Amodio PM, et al. Hemoperitoneum from a spontaneous rupture of a giant hemangioma of the liver: report of a case. Surg Today. 2003;33(6):459-63.
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| *Arnoletti JP, Brodsky J. Surgical treatment of benign hepatic mass lesions. Am Surg. May 1999;65(5):431-3.
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| *Srivastava DN, Gandhi D, Seith A, et al. Transcatheter arterial embolization in the treatment of symptomatic cavernous hemangiomas of the liver: a prospective study. Abdom Imaging. Sep-Oct 2001;26(5):510-4.
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| *Zeng Q, Li Y, Chen Y, et al. Gigantic cavernous hemangioma of the liver treated by intra-arterial embolization with pingyangmycin-lipiodol emulsion: a multi-center study. Cardiovasc Intervent Radiol. Sep-Oct 2004;27(5):481-5.
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| *Rokitansky AM, Jakl RJ, Gopfrich H, et al. Special compression sutures: a new surgical technique to achieve a quick decrease in shunt volume caused by diffuse hemangiomatosis of the liver. Pediatr Surg Int. Nov 1998;14(1-2):119-21.
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| *Tak WY, Park SY, Jeon SW, et al. Ultrasonography-guided percutaneous radiofrequency ablation for treatment of a huge symptomatic hepatic cavernous hemangioma. J Clin Gastroenterol. Feb 2006;40(2):167-70.
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| *Fan RF, Chai FL, He GX, et al. Laparoscopic radiofrequency ablation of hepatic cavernous hemangioma. A preliminary experience with 27 patients. Surg Endosc. Feb 2006;20(2):281-5.
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| *Biswal BM, Sandhu M, Lal P, et al. Role of radiotherapy in cavernous hemangioma liver. Indian J Gastroenterol. Jul 1995;14(3):95-8.
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| *Tepetes K, Selby R, Webb M, et al. Orthotopic liver transplantation for benign hepatic neoplasms. Arch Surg. Feb 1995;130(2):153-6.
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| {{refend}}
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