Hepatic hemangioma in childhood: Medical management or surgical management?

Hepatic artery embolisation; successful treatment of multinodular haemangiomatosis of the liver

“…If CHF develops digoxin and diuretics ought to be given. Steroids have shown to be of additional value, causing faster involution of the haemangiomas [1,13]. According to Larcher [8] and Nguyen et al [i3] radiotherapy has been used successfully to hasten resolution of haemangiomas.…”

“…These tumours usually regress spontaneously within the first year of life [1,16]. However, haemangiomas of the liver are rare in childhood and may present considerable problems in diagnosis and treatment [13]. Although in these cases spontaneous regression may occur as well, an overall mortality of 70% has been reported [8,13] due to congestive heart failure [11] and haemorrhages [131.…”

Benign Hepatic Neoplasms

“…As a result of the numerous venous lakes within these lesions, which serve as siphons for a large proportion of the total cardiac output, severe congestive heart failure and death may result. Initial treatment of high output cardiac failure in children includes oxygen, diuretics, digitalis, corticosteroids, hepatic artery ligation, and radiation therapy [2,[45][46][47][48]. Contrary to the conservative management of adult hemangiomas, hemangiomas of infancy and childhood more frequently require life-saving surgical intervention.…”

“…While typically small (< 5 cm), FNH lesions have been reported as large as 19 cm [48,50]. The majority of FNH lesions are solitary in nature (80%-95%), although up to 20% of individuals are reported to have multiple lesions [1,48,50].…”

“…The majority of FNH lesions are solitary in nature (80%-95%), although up to 20% of individuals are reported to have multiple lesions [1,48,50]. When multifocal, FNH often occurs in conjuncture with other benign hepatic lesions including hemangiomas [58].…”