A hepatic sclerosed hemangioma with significant morphological change over a period of 10 years: a case report

Abstract

IntroductionLiver cavernous hemangioma is the most common noncystic hepatic lesion, and a hemangioma that undergoes degeneration and fibrous replacement is called a hepatic sclerosed hemangioma.Case presentationA 63-year-old Japanese man was admitted for detailed investigation of a liver tumor. Tumor markers carcinoembryonic antigen, alpha-fetoprotein, and CA19-9 levels in the peripheral blood were not elevated at any time. Plain computed tomography showed an approximately 1.5cm low density mass in the periphery of segment 8, which was marginally enhanced on contrast-enhanced dynamic computed tomography. On magnetic resonance imaging, the tumor was hypointense on T1-weighted image and hyperintense on T2-weighted image. The tumor was suspected to be an atypical hemangioma, metastatic, hepatocellular carcinoma, or cholangiocellular carcinoma. Segmental hepatectomy was performed. Histological examination of the resected tumor specimen revealed a sclerosed hemangioma with marked hyalinization and sparse stromal fibrosis. Immunochemically, the tumor cells were positive for CD34 and alpha smooth muscle actin. Electron microscopically, the residual hemangioma consisted of numerous caveolae and vesicles in endothelial cells in irregular shapes and sizes. Immunostaining for caveolin-1 showed decreased or no caveolin-1 reactivity in the hyalinized lesions of the sclerosed hemangioma, but abundant caveolin-1 reactivity in the residual cavernous hemangioma. Of interest, computed tomography images of the tumor obtained 10 years earlier at our hospital depicted a 3cm typical cavernous hemangioma.ConclusionsHepatic sclerosed hemangioma is a rare condition. Comparison of radiological findings of the lesion over a period of 10 years was valuable in providing insight for the evolutional process from liver cavernous hemangioma to hepatic sclerosed hemangioma.

Hepatic Sclerosed Hemangioma: a case report and review of the literature

“…Additionally, we found 22 cases in ICHUSHI, a bibliographic database established in 1903 and being updated by the Japan Medical Abstracts Society, contains bibliographic citations and abstracts from more than 2500 biomedical journals and other serial publications published in Japanese. The 32 cases, including our case, are summarized in Table 1 [ 1 , 4 - 33 ].…”

Multiple hepatic sclerosing hemangioma mimicking metastatic liver tumor successfully treated by laparoscopic surgery: Report of a case

“…Sclerosing hemangioma is a rare type of hepatic hemangioma composed of abundant acellular hyalinized tissue in which small vessels are occasionally seen [1] . Only 17 resected cases, including the present case, with detailed information on patients with hepatic sclerosing hemangioma have been reported in the English literature ( Table 1 ) [3–17] . To the best of our knowledge, this report is the first to describe multiple hepatic sclerosing hemangiomas treated by laparoscopic surgery.…”

Sclerosed Hemangioma Accompanied by Multiple Cavernous Hemangiomas of the Liver

“…In contrast, sclerosed hemangioma is a rare condition found in only 2 of 1000 autopsy cases [ 7 ]. Sclerosed hemangioma accompanies cavernous hemangioma or preexisting cavernous hemangioma changes to sclerosed hemangioma over a period of many years [ 3 ]; sclerosed hemangioma is thought to be the terminal stage of degeneration of a cavernous hemangioma. Cavernous hemangioma is more commonly seen in young adult women while sclerosed hemangioma is seen more in older women [ 4 ].…”

“…We have reviewed the English literature from PubMed Central and collected precisely described case reports that included pathological information. Eight cases including the present case were collected under the keyword “sclerosed hemangioma” and are listed in Table 1 [ 3 , 4 , 8 – 12 ]. The patients had a relatively high age (range, 40–81; average, 66.3 years) and male: female ratio was 1:1.…”

“…Solitary necrotic nodule is a broad term that includes not only sclerosed hemangiomas but also parasitic infection and trauma [ 2 ]. Sclerosed hemangioma is characterized by sclerosis and hyalinization occurring in association with degeneration of a cavernous hemangioma of the liver [ 3 ]. Although sclerosed hemangioma is a benign condition, its radiological features resemble those of hepatic malignancies such as hypovascular adenocarcinomas including cholangiocarcinomas, fibrolamellar hepatocellular carcinomas, or metastatic liver cancers [ 4 ].…”