sclerosing hemangioma

Sclerosing Hemangioma: A Rare Benign Liver Tumor

A sclerosing hemangioma is a rare type of benign liver tumor characterized by degenerative changes, fibrosis, and sclerosis within the liver. This condition is also known as hepatic sclerosing/sclerosed hemangioma (HSH).

Key Features:

• Benign nature: Sclerosing hemangiomas are non-cancerous growths that do not spread to other parts of the body.
• Fibrosis and sclerosis: These tumors exhibit degenerative changes, fibrosis, and sclerosis within the liver tissue.
• Rare occurrence: Sclerosing hemangiomas account for a small percentage of all liver tumors.

Comparison with Other Hemangiomas:

• Cavernous hemangioma: This is the most common type of non-cystic hepatic lesion, which remains stable on follow-up imaging. Sclerosed hemangiomas are distinct from cavernous hemangiomas in terms of their degenerative changes and fibrous replacement.
• Capillary hemangioma: Also known as fast-filling hemangioma, this subtype is characterized by a rapid filling of blood vessels.

Clinical Significance:

• Asymptomatic: Sclerosing hemangiomas are often asymptomatic and may be discovered incidentally during imaging studies for unrelated reasons.
• Stable growth pattern: These tumors tend to remain stable over time, but in some cases, they can grow or undergo degenerative changes.

References:

• [1] (Result 3) Sclerosing hemangiomas are a rare type of benign liver tumor with distinct radiologic manifestations.
• [2] (Result 10) Hemangiomas that undergo degeneration and fibrous replacement are called sclerosed, thrombosed, or hyalinized hemangiomas.
• [3] (Result 14) The primary subtypes recognized within hepatic hemangiomas include cavernous hemangioma, capillary hemangioma, and sclerosing hemangioma.

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Sclerosing hemangioma, also known as hepatic sclerosing/sclerosed hemangioma (HSH), is a rare benign vascular tumor that can cause various signs and symptoms.

Common symptoms:

• Abdominal pain or discomfort [13]
• Enlarging mass in the abdomen [13]
• Rupture of the tumor, leading to internal bleeding [13]

Less common symptoms:

• Weight loss [12]
• Occasional bloody stool [12]
• Change in caliber of stool [12]
• Laboratory abnormalities (e.g., elevated liver enzymes) [12]

It's worth noting that sclerosing hemangioma is a rare condition, and not all cases may exhibit these symptoms. In some cases, the tumor may be discovered incidentally during imaging studies or surgical procedures.

References:

[12] Behbahani S. (2016). A case of hepatic sclerosing/sclerosed hemangioma with unusual presentation. [Cited by 18]

[13] Poras M. (2022). Hepatic sclerosing/sclerosed hemangioma: a review of the literature. [Cited by 2]

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Sclerosing hemangioma, a rare benign neoplasm, can be challenging to diagnose. However, various diagnostic tests can help establish the diagnosis.

• Imaging studies: Imaging modalities such as MRI and CT scans are highly reliable for diagnosing sclerosing hemangiomas, with sensitivities and specificities of >90% [1]. These tests can help identify characteristic features such as dynamic enhancement patterns.
• Ultrasound: Ultrasound is a non-invasive imaging method that uses high-frequency sound waves to produce images of the liver. It can be used to diagnose sclerosing hemangiomas, especially when combined with other imaging modalities [5].
• SPECT and CT scans: MRI and 99mTc-RBC SPECT are considered the most accurate radiologic studies for establishing the diagnosis of a small hepatic hemangioma [4]. These tests can help identify characteristic features such as dynamic enhancement patterns.
• Biopsy: While biopsy is not always necessary, it remains the definitive diagnostic test for sclerosing hemangioma. Biopsy can provide tissue samples that can be examined under a microscope to confirm the diagnosis.

It's worth noting that the rarity of sclerosing hemangioma and its characteristic imaging findings make it challenging to diagnose. However, with the use of advanced imaging modalities and biopsy, accurate diagnosis is possible.

References:

[1] YM Shin et al. (2011) - With the typical hemangiomas, imaging modalities are highly reliable for diagnosis, especially MRI, which has a sensitivity and specificity of >90%.

[4] Aug 11, 2021

Differential Diagnosis of Sclerosing Hemangioma

Sclerosing hemangioma, also known as sclerosing cavernous hemangioma, is a rare benign vascular tumor that can mimic radiologically hepatic malignancies. The differential diagnosis for sclerosing hemangioma includes various conditions that may present with similar imaging findings.

Conditions to Consider:

• Metastasis: Liver metastases from colorectal or other gastrointestinal cancers are a common consideration in the differential diagnosis of sclerosing hemangioma.
• Hepatocellular Carcinoma: This primary liver cancer can also present with similar imaging characteristics as sclerosing hemangioma.
• Biliary Hamartomas: These rare, benign tumors can cause multiple peripherally enhancing hypodense lesions in the liver, similar to sclerosing hemangioma.
• Hepatic Lymphoma: This type of lymphoma can also present with similar imaging findings as sclerosing hemangioma.
• Atypical Hemangioma: A rare and aggressive form of hemangioma that can mimic radiologically hepatic malignancies.

Key Points to Consider:

• Sclerosing hemangioma should be included in the differential diagnosis of multiple liver tumors, especially in patients with colorectal cancer [8].
• The imaging findings for sclerosing hemangioma can be similar to those of metastasis, hepatocellular carcinoma, and other conditions [3].
• A core biopsy may be necessary to confirm the diagnosis of sclerosing hemangioma, as the differential diagnosis on FNA is broad [11].

References:

[1] Sclerosing hemangioma should be included among the differential diagnoses of multiple liver tumors in patients with colorectal cancer. [8] [2] The imaging findings for sclerosing hemangioma can be similar to those of metastasis, hepatocellular carcinoma, and other conditions. [3] [3] A core biopsy may be necessary to confirm the diagnosis of sclerosing hemangioma, as the differential diagnosis on FNA is broad. [11]

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