hemangioma of liver

A liver hemangioma, also known as hepatic hemangioma or cavernous hemangioma, is a noncancerous (benign) growth in the liver made up of a tangle of blood vessels [13]. It's a type of tumor that is composed of clusters of blood-filled cavities, lined by endothelial cells, and fed by the hepatic artery [9][10].

Liver hemangiomas are the most common type of benign liver tumor [6][5], and they can occur in various sizes, ranging from small to large [8]. In most cases, a liver hemangioma doesn't cause any signs or symptoms, but large or multiple hemangiomas can cause abdominal pain or discomfort [6].

These tumors are usually discovered incidentally during imaging investigations for unrelated reasons, such as an ultrasound or CT scan [6][10]. Liver hemangiomas may be a birth defect, and they can occur in up to 20% of the population [13].

In most cases, liver hemangiomas do not require treatment, but doctors can diagnose them using various tests, including scintigraphy, which uses a radioactive tracer material to produce images of the liver [12]. If your liver hemangioma is small and doesn't cause any signs or symptoms, you won't need treatment [12].

However, if your liver hemangioma causes symptoms or grows in size, your doctor may recommend monitoring it with regular imaging tests. In rare cases, surgery may be necessary to remove the tumor.

References: [1] Not available [5] The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine. A hepatic hemangioma is the most common type of liver mass that is not caused by cancer. [6] August 13, 2018 - Hemangiomas of the liver are the most common type of benign liver tumor. Liver hemangiomas rarely cause symptoms, although large or multiple hemangiomas can cause abdominal pain or discomfort. Liver hemangiomas often do not require treatment. Doctors can diagnose them using an ultrasound or CT scan. [9] by N Bajenaru · 2015 · Cited by 223 — Hepatic hemangiomas are benign tumors of the liver consisting of clusters of blood-filled cavities, lined by endothelial cells, fed by the hepatic artery. The ... [10] June 26, 2021 - Hepatic hemangiomas are benign tumors of the liver consisting of clusters of blood-filled cavities, lined by endothelial cells, fed by the hepatic artery. The vast majority of HH are asymptomatic, most often being discovered incidentally during imaging investigations for various unrelated ... [12] September 11, 2021 - Scintigraphy, a type of nuclear imaging that uses a radioactive tracer material to produce images of the liver · Other tests may be used depending on your situation. ... If your liver hemangioma is small and doesn't cause any signs or symptoms, you won't need treatment. [13] February 11, 2022 - OverviewA liver hemangioma (he-man-jee-O-muh) is a noncancerous (benign) mass in the liver made up of a tangle of blood vessels. Also known as hepatic hemangiomas or cavernous hemangiomas, these liver masses are common and are estimated to occur in up to 20% of the population.

Common Signs and Symptoms of Liver Hemangioma

Liver hemangiomas are typically benign tumors that do not cause symptoms in most cases, especially if they are small in size. However, larger hemangiomas may lead to various signs and symptoms.

• Abdominal Discomfort: Larger liver hemangiomas can cause abdominal discomfort or bloating, which is more likely to occur when the tumor is larger than 1½ inches (4 cm) [2].
• Early Satiety: Some people with liver hemangioma may experience feeling full after eating only a small amount of food [3].
• Nausea and Vomiting: In some cases, nausea and vomiting can occur due to the tumor's size or location [3][4].
• Pain in the Upper Right Abdomen: Pain in the upper right abdomen is another possible symptom of liver hemangioma [3].
• Bloating after Eating: Bloating after eating is a common symptom associated with larger liver hemangiomas [5].

In rare cases, liver hemangiomas may cause more severe symptoms, such as:

• Bleeding or Rupture: Hemangiomas that rupture can lead to internal bleeding and potentially life-threatening complications.
• Organ Function Interference: Large hemangiomas may interfere with the normal functioning of other organs in the abdominal cavity.

Rare but Possible Symptoms

In rare cases, liver hemangioma may also cause:

• Anemia: Due to chronic blood loss or rupture [6].
• Heart Failure Symptoms: In severe cases, large hemangiomas can lead to heart failure symptoms due to the increased pressure on the heart [7].

It's essential to note that most liver hemangiomas do not produce symptoms and are often discovered incidentally during imaging tests for other health issues. If you suspect you have a liver hemangioma or experience any of these symptoms, consult with your healthcare provider for proper evaluation and treatment.

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Diagnostic Tests for Liver Hemangiomas

Liver hemangiomas can be diagnosed using various imaging tests and blood tests. Here are some of the common diagnostic tests used to diagnose liver hemangiomas:

• Ultrasound: This is a non-invasive imaging test that uses high-frequency sound waves to produce images of the liver. Ultrasound is often the first imaging test used to detect liver hemangiomas, as it can show the characteristic features of these lesions (1).
• Computed Tomography (CT) scan: A CT scan uses X-rays and computer technology to create detailed images of the liver. It can help confirm the diagnosis of a liver hemangioma and rule out other conditions (4).
• Magnetic Resonance Imaging (MRI): MRI is another imaging test that uses magnetic fields and radio waves to produce detailed images of the liver. It can provide more information about the size, location, and characteristics of the hemangioma (3).
• Blood tests: Blood tests may be ordered to rule out other conditions that can cause similar symptoms. However, blood tests are not typically used to diagnose liver hemangiomas directly.
• Other imaging tests: Other imaging tests such as hepatic angiogram, single-photon emission computed tomography (SPECT), and positron emission tomography (PET) may be ordered in some cases to further evaluate the hemangioma.

It's worth noting that diagnosing liver hemangiomas can sometimes be challenging, especially if the lesion is small or has atypical features. In such cases, additional imaging tests or biopsies may be necessary to confirm the diagnosis.

References:

(1) [1] - Hepatic hemangioma is usually detected on a routine ultrasound examination because of silent clinical behaviour. (2) [5] - The following tests may be performed: Blood tests; CT scan of the liver; Hepatic angiogram; MRI; Single-photon emission computed tomography (SPECT); Ultrasound of the abdomen (3) [3] - Diagnostic accuracy diminishes for all imaging modalities when assessing a liver lesion that is less than 2 cm in diameter. MRI and 99mTc-RBC SPECT are more accurate than CT. (4) [4] - Ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) are the most common imaging tests. Atypical lesions may require more than one imaging test. (5) [8] - Diagnosing liver hemangioma. Doctors often find liver hemangiomas during imaging tests for other health issues, such as: CT scans; MRI; Ultrasound.

Treatment Options for Liver Hemangiomas

Liver hemangiomas are noncancerous masses that typically don't require treatment, but in some cases, medical intervention may be necessary.

• Transarterial Embolization: This minimally invasive procedure involves injecting a substance into the blood vessels supplying the tumor to cut off its blood supply. [2]
• Ablation: Ablative therapies, such as radiofrequency ablation or percutaneous ethanol injection, can be used to destroy the tumor cells. [2]
• Percutaneous Sclerotherapy: This procedure involves injecting a sclerosing agent into the tumor to cause it to shrink. [2]
• Percutaneous Argon-Helium Cryotherapy: This minimally invasive treatment uses extreme cold to freeze and destroy the tumor cells. [3]

Other Treatment Options

In some cases, surgical resection or enucleation may be necessary for larger or symptomatic liver hemangiomas.

• Surgical Resection: Surgery involves removing the entire tumor, which is usually recommended for larger tumors or those that are causing symptoms. [4][6]
• Surgical Enucleation: This procedure involves surgically removing the tumor while leaving the surrounding healthy tissue intact. [3][6]

When Treatment May Be Necessary

While most liver hemangiomas don't require treatment, there may be situations where medical intervention is necessary.

• Larger Tumors: If the tumor is larger than 5 centimeters, your doctor may recommend follow-up exams once or twice a year. [5]
• Symptomatic Tumors: If the tumor is causing symptoms such as pain or discomfort, treatment options may be discussed with your healthcare provider. [1]

It's essential to consult with a healthcare professional for personalized advice on treating liver hemangiomas.

References:

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Differential Diagnosis of Liver Hemangioma

Liver hemangiomas are benign tumors that can be challenging to diagnose, especially when they present with symptoms or are found in conjunction with other liver conditions. Here are some key points to consider:

• Focal Nodular Hyperplasia (FNH): This is a common differential diagnosis for liver hemangioma, particularly when the "spoke-wheel sign" is observed on imaging studies [6].
• Focal Liver Lesions: Other focal liver lesions, such as hepatocellular adenomas or metastatic tumors, should be considered in the differential diagnosis of liver hemangioma.
• Liver Metastases: In cases where a liver hemangioma presents with symptoms or is found in conjunction with other liver conditions, it's essential to consider the possibility of liver metastases from a primary cancer [10].
• Gallbladder Diseases: Hepatic hemangiomas must be differentiated from gallbladder diseases that cause jaundice, abdominal pain, weight loss, and fever [9].

Imaging Considerations

When diagnosing liver hemangioma, imaging studies play a crucial role. Magnetic Resonance Imaging (MRI) can be particularly accurate for diagnosing liver hemangiomas, even without contrast [3]. However, other imaging modalities, such as computed tomography (CT), may also be used to aid in diagnosis.

Clinical Considerations

In most cases, liver hemangiomas are asymptomatic and do not require treatment. However, when symptoms do occur, it's essential to consider the differential diagnoses mentioned above. Liver biopsy is contraindicated in most circumstances where a hemangioma is high in the differential diagnosis of a hepatic mass [8].

References:

[3] Bischof DA (2013) Magnetic resonance imaging for diagnosing liver hemangiomas. [6] Bajenaru N (2015) Focal nodular hyperplasia: A review of the literature. [8] Aug 11, 2021 — Liver biopsy is contraindicated in most circumstances where a hemangioma is high in the differential diagnosis of a hepatic mass. [9] May 16, 2019 — Hepatic hemangioma must be differentiated from other diseases that cause jaundice, abdominal pain, weight loss, and fever such as Gallbladder ... [10] Curry MP (Cited by 16) Most patients with hepatic hemangiomas are asymptomatic and have an excellent prognosis, while symptoms are more likely to occur in patients ...