A growing liver anastomosing hemangioma

Hepatic anastomosing hemangioma: description of a rare case and a literature analysis

“…In the case reported by Rogers et al , hepatic AH demonstrated no restricted diffusion ( 10 ), which is similar to a recently published case of retroperitoneal AH ( 15 ). In a previously published hepatic AH case at our hospital ( 14 ), the lesion showed no obviously restricted diffusion, with a mean an ADC value of 1.81×10 -3 mm 2 /s. Previous studies have reported that ADC values of hepatic hemangiomas [approximately (1.9–2.3)×10 −3 mm 2 /s], including hemangiomas with both typical and atypical enhancement, were significantly larger than those of other hypervascular lesions, such as hepatocellular carcinoma, focal nodular hyperplasia, and neuroendocrine tumor ( 16 , 17 ).…”

“…On MRI, hepatic AHs typically demonstrate high intensity on T2WI and low intensity on T1WI, with similar enhancing presentation to that on CT ( 5 , 7 , 8 , 10 , 11 , 14 ). The most common enhancement patterns of reported hepatic AHs can be summarized into 2 distinct types: the first is homogeneous persistent hyperenhancement during arterial phase without subsequent washout in the portal venous or equilibrium phases ( 7 , 8 , 10 , 13 ), and the second type is a thick, continuous, rim-like enhancement in the arterial phase with progressively centripetal filling during the portal venous and equilibrium phases ( 5 , 7 , 11 , 14 ); the latter is consistent with our case. Central unenhanced areas in equilibrium or delayed phases are hypothesized to result from thrombosis or hyaline degeneration.…”

“…AH is a rare benign vascular tumor, and it is exceedingly uncommon for this entity to occur in the liver. Currently, only 23 cases of hepatic AH have been reported in the English-language literature ( 2 - 14 ) ( Table 1 ), and thus our paper holds considerable significance for the future collection of imaging features and understanding of the natural course of this tumor.…”

“…On ultrasound, the tumor is usually observed as a well-defined mass with varied echogenicity ( 7 , 13 , 14 ). Unlike the more prevalent cavernous hemangioma, hypoechoic areas are often present within this entity.…”

“…The color Doppler imaging features can range from small amounts of dotted blood flow signals to intense vascularity. On computed tomography (CT), the lesions show iso- or hypodensity and display persistent uniform enhancement or peripheral rim-like enhancement with centripetal filling ( 6 , 7 , 11 , 12 , 14 ). Calcifications and necrosis are rarely observed.…”