Giant hepatic hemangioma versus conventional hepatic hemangioma: Clinical findings, risk factors, and management

Abstract

Background: Giant hepatic hemangiomas (GHHs) are those that are larger than 4 cm in size. Aims: The aim of this study was to describe GHH clinical findings, their risk factors, diagnostic approach and management, and to compare these data with those of conventional hemangiomas. Methods: We performed a retrospective analysis of patients diagnosed with hemangiomas, whether by imaging studies or histopathology, at our hospital within the time frame of 1990-2008. The medical records of each patient were reviewed to obtain clinical and surgical data. Results: Of the 57 patients with liver hemangioma, 41 (72%) were women and 32 (56%) had GHH. Liver hemangioma median size was 4.49 cm. In regard to the patients with GHH, 31.2% were asymptomatic and when symptoms presented, pain was the most common. Both symptoms and oral contraceptive exposure were more common in the GHH patients. Nine patients with GHH underwent surgery: 2 open biopsies due to diagnostic uncertainty, one enucleation, and 6 resections.

Giant Hepatic Hemangioma Regressed Significantly Without Surgical Management: A Case Report and Literature Review

“…However, they also do not regress or disappear spontaneously, with possible expansion or dilation of the affected vessels during growth spurts and puberty ( 23 ). Follow up is suggested for patients with giant hemangiomas defined as tumors larger than 4 cm ( 28 , 32 ). Our patient had multiple HHs, and the largest HH was 75 × 61 mm in size on US in March 2013, indicating that his HHs were giant HHs.…”

“…The largest HH in the S6/7/8 liver segment was 86 × 81 × 81 mm in size on MRI in March 2014, suggesting that his HHs did not regress compared with that on US in March 2013. For patients with huge HHs or symptoms such as rapid tumor growth, persistent pain, pressure on adjacent organs or hemorrhage, treatment is recommended (28,31,32). Currently, the most preferred treatment methods, particularly for huge HHs, include surgical resection, transcatheter angiography embolization (TAE), radiofrequency ablation, radiotherapy or, in some cases, orthotopic liver transplantation (1,(31)(32)(33).…”

“…For patients with huge HHs or symptoms such as rapid tumor growth, persistent pain, pressure on adjacent organs or hemorrhage, treatment is recommended (28,31,32). Currently, the most preferred treatment methods, particularly for huge HHs, include surgical resection, transcatheter angiography embolization (TAE), radiofrequency ablation, radiotherapy or, in some cases, orthotopic liver transplantation (1,(31)(32)(33). However, the optimal surgical approach, either segmental resection or enucleation of the tumor based on the location of the lesion, remains controversial (33,34).…”

A Case-Control Study on the Relationship Between Cholecystectomy and Cholangiocarcinoma in China

“…Based on logistic multivariate regression analysis, we found that the difference of gender and diabetes between the case group and the negative control group was even more statistically signi cant. Which indicated that female patients are more likely to suffer from hepatic hemangioma and femoral fracture, and some studies supported this conclusion [36,37]. Furthermore, it has been reported that patients with type 2 diabetes have increased BMD (bone mineral density) but impaired structure and mineral properties,…”

Interventional treatments for hepatic hemangioma: A state-of-the-art review

“…However, multiple large HHs can present with symptoms such as abdominal pain, nausea, vomiting, and loss of appetite, indicating the necessity of treatment. 18 , 19 The spontaneous or traumatic rupture of HHs is rare and typically results in acute abdominal pain and hemorrhagic shock; however, once rupture occurs, the mortality rate becomes considerably high (36–39%). 20 Compared with spontaneous or traumatic rupture of HH, the incidence of intratumoral hemorrhage is even lower, associated with atypical clinical symptoms, and only 9 cases have been reported worldwide.…”