Hepatic hemangioma

Hepatic hemangioma
Heptatic hemangioma. Image courtesy of RadsWiki

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Contributors: Cafer Zorkun M.D., PhD.

Overview

Hepatic hemangioma is the most common primary liver tumor.

Incidence

Ranges from 0.4-20% of the population. M:F = 1:5

Pathogenesis

• 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.
• They may be associated with focal nodular hyperplasia.
• May be associated with Kasabach-Merritt syndrome: Hemolytic anemia and consumptive coagulopathy

Diagnosis

They are frequently asymptomatic and incidentally discovered at imaging, surgery, or autopsy.

Ultrasonography

• Echogenic
• Homogenous

Computed Tomography

• Noncontrast: Hypointense to liver
• Portal venous enhancement: Peripheral nodular enhancement
• Delayed enhancement: Lesion fills in the contrast

MRI

• T2 hyperintense
• Portal venous enhancement: Peripheral nodular enhancement
• Delayed enhancement: Lesion fills in the contrast

Scintigraphy

• Tc99-labeled red blood cells show decreased activity on early dynamic images and increased activity on delayed images (i.e. 1-2 hours).
• Only sensitive for larger lesions.

Diagnostic Findings

Images courtesy of RadsWiki

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  T1 post Gad coronal

Related Chapters

• Infantile hemangioendothelioma

References & Additional Resources

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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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• 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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• 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.

• 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.

• Arnoletti JP, Brodsky J. Surgical treatment of benign hepatic mass lesions. Am Surg. May 1999;65(5):431-3.

• 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.

• 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.

• 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.

• 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.

• 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.

• Biswal BM, Sandhu M, Lal P, et al. Role of radiotherapy in cavernous hemangioma liver. Indian J Gastroenterol. Jul 1995;14(3):95-8.

• 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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