Hypergiant Hepatic Hemangiomas: Case Series

Adhikari, Devbrata; Thakur, Vishal Vishnu; Telavane, Parag P.; Kulkarni, Rishabh; Singh, Rajinder; Joshi, Rajeev

doi:10.1007/s12262-014-1104-8

Cited by 10 publications

(6 citation statements)

References 8 publications

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“…Unlike the less common capillary-type haemangiomas, which are generally smaller in size, multiple and most commonly asymptomatic cavernous haemangiomas can grow to a large size and may become symptomatic. Giant haemangiomas are defined as those measuring ≥5 cm, while hypergiant hepatic haemangiomas are defined as those which are larger than 10 cm in size [ 11 ]. These lesions are more frequent in women (female:male ratio = 5:1), with a mean age at diagnosis of 50 years [ 12 ].…”

Section: Resultsmentioning

confidence: 99%

Indications for liver surgery in benign tumours

et al. 2018

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SummaryBackgroundManagement of benign liver tumours (BLT) is still object of discussion. Uncertainty still exists about patient selection, details of management, indications for surgical intervention and potential surgery-related complications. The up-to-date strategies for management of the most common benign solid tumours are recapitulated in this article. In addition, recommendations concerning practical issues are presented.MethodsAvailable data from peer-reviewed publications associated with the major controversies concerning treatment strategies of solid BLT were selected through a PubMed literature search.ResultsNon-randomized controlled trials, retrospective series and case reports dominate the literature. Conservative management in BLT is associated with low overall morbidity and mortality when applied in an appropriate patient population. Surgical intervention is indicated solely in the presence of progressive symptoms and suspicion of a malignant change. Linking abdominal symptoms to BLT should be interpreted with caution. No evidence is recorded for malignant transformation in haemangiomas and focal nodular hyperplasia (FNH), while a subgroup of hepatocellular adenoma (HCA) is associated with malignancy. Follow-up controls of BLT at 3 and 6 months should be sufficient to prove the stability of the lesion and its benign nature, after which no long-term follow-up is required routinely. However, many questions regarding this topic remain without definitive answers in the literature.ConclusionConservative management of solid BLT is a worldwide trend, but the available literature does not provide high-grade evidence for this strategy. Consequently, further prospective investigations on the unclear aspects are required. Hence, this article summarises practical highlights of therapeutic strategies.

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Section: Resultsmentioning

confidence: 99%

Indications for liver surgery in benign tumours

et al. 2018

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“…Due to the mass effect, large hemangiomas can cause compression of the adjacent structures and produce symptoms such as obstructive jaundice and gastric outlet obstruction [ 10 , 11 ]. In addition, it is possible for intra-tumoral hemorrhage, spontaneous tumor rupture, disseminated intravascular consumptive coagulopathy (Kasabach-Merritt syndrome) to occur in patients with giant hepatic hemangiomas [ 10 , 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical management of giant hepatic hemangioma: A 10-year single center experience

Farhat

Ammar

Said

et al. 2021

Annals of Medicine &Amp; Surgery

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Background Hepatic hemangiomas are the most typical benign mesenchymal lesions of the liver. Most of these lesions are asymptomatic. Giant hepatic hemangiomas (GHH) (>10 cm) are often symptomatic and require surgical intervention. This study aimed to describe the clinical findings, risk factors, diagnostic approach and management of GHH. Methods We performed a retrospective analysis of patients with GHH treated at our hospital from January 2008 to December 2018. The medical records of each patient were reviewed to obtain the clinical and surgical data. Results Twelve patients with GHH were treated during the study period. 9 were female and 3 were male. The mean age of diagnosis was 48,2 years. The most common presenting symptom was abdominal pain. Eight patients presented an abdominal mass. Indications for surgical resections were rupture (n = 2), Kasabach-Merritt syndrome (n = 1) and abdominal pain (n = 9). Right hepatectomy was done in four patients, left lobectomy in four patients, and enucleation in four patients. Embolization was performed in 4 patients, but due to the persistence of symptoms or bleeding, surgery was indicated. The mean operative time was 3.5 h, and median blood loss was 870 ml. The median hospital stay was 5.3 days. For four patients, we registered postoperative complications causing death in one case. All alive patients were asymptomatic at a median follow-up of 55 months. Conclusion Despite limitations and alternative modalities, surgery remains the only effective curative treatment for GHH.

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“…They are defined as greater than 5 cm, hypergiant haemangiomas as >10 cm. 4 Due to their size they can cause various complaints and often need some form of treatment. Transarterial chemoembolization (TACE), radiofrequency (RFA) or microwave ablations (MWA) are possible non-surgical treatment strategies for haemangiomas, which can be applied to decrease the growth.…”

Section: Discussionmentioning

confidence: 99%

“…Previously described surgical treatments were TACE before surgical resection, enucleation or conventional right or left liver resection. 4 , 10…”

Section: Discussionmentioning

confidence: 99%

Extended liver resection including hypertrophy concept with portal venous embolisation for giant haemangioma. Too much surgery?

Strohmaier

Wagner

Reese

et al. 2020

Ann Hepatobiliary Pancreat Surg

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Haemangiomas of the liver are benign tumours, which are often diagnosed randomly. With an increase in size haemangiomas could become symptomatic. In this case therapeutic options, surgical or interventional, have to be weighted to a conservative approach. We present a case of a 36-year old woman with a symptomatic giant haemangioma of the right liver lobe. Because of the size of the tumor and the small future liver remnant we decided to perform a major liver resection after hypertrophy induction with a preoperative portal vein embolization; an option mainly used for major hepatectomies in malignant tumors of the liver. But however, this case shows, that using a hypertrophy concept also for benign liver tumours is the safer approach, if an extended resection is necessary and the future liver remnant is critical.

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Hypergiant Hepatic Hemangiomas: Case Series

Cited by 10 publications

References 8 publications

Indications for liver surgery in benign tumours

Indications for liver surgery in benign tumours

Surgical management of giant hepatic hemangioma: A 10-year single center experience

Extended liver resection including hypertrophy concept with portal venous embolisation for giant haemangioma. Too much surgery?

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