Imaging and Pathologic findings of Hepatic Small Vessel Hemangioma

Case report: a rare cause of a hypervascular nodule in a noncirrhotic liver

“…cases very difficult [2]. In a recent report on 2 cases of histologically confirmed hepatic small vessel neoplasm, contrast-enhanced MRI was performed in 1 patient and showed strong enhancement in the arterial phase with continuous and complete enhancement in the venous phase [6]. A similar pattern of enhancement was reported on the CT scan of a hepatic small vessel neoplasm with marked enhancement in the arterial phase and progressive filling in the late phase without washout [7].…”

“…A cutoff of 10 % ki67 positivity has been reported with a 100 % sensitivity and specificity for the discrimination between hepatic small vessel neoplasm and hemangiosarcoma [2]. In accordance to the low mitotic activity of published cases, the presented tumor showed neither a significantly elevated ki67 proliferation index nor p53 overexpression [2,6,7].…”

“…Since the term has only recently been coined [2], clinical reports are rare [3,6,7], and retrospective (re-)classification of similar cases is hampered by incomplete histopathological descriptions, different imaging modalities, and a varying focus of the reported cases.…”

Malignant Vascular Tumors of the Liver in Adults

“…No cases of HSVN described hitherto presented rupture/ hemorrhage or disseminated intravascular coagulation. Thus far, there has been no metastasis or recurrence of HSVN, but, as recently reinforced by Rangaswamy et al, 80 complete resection and close clinical follow-up are recommended as the outcome remains unknown.…”

“…Usually, it appears as a homogeneous mass that strongly enhances in the early phases of the dynamic study, with varied enhancement patterns in the late phase. 79,80 We have recently collaborated to an international network study headed by Gill et al, 81 collecting 17 of these cases, unified under the category of "hepatic small vessel neoplasm (HSVN)," a tumor more common in adult men (mean age: 54 years), usually without comorbidities. Lewis et al 79 reported a similar case of small vessel hemangioma occurring in a patient with cirrhosis.…”