Abstract:We report 2 cases of isolated hepatic hemangiomatosis: a 76-year-old woman who is, to our knowledge, the oldest person with this diagnosis, and a 74-year-old woman. Magnetic resonance imaging of the abdomen showed T2 hyper intense lesions throughout the liver, peripheral nodular arterial enhancement, and filling of contrast on the portal venous and delayed phases. Computed tomography showed liver lesions with peripheral nodular enhancement in the early phase and a centripetal pattern or “filling in” during the… Show more
“…3 ). These characteristics were consistent with the diagnosis of liver hemangiomatosis [6] and biopsy was not performed due to the absence of chronic liver disease, normal laboratory tests and the evaluation of the imaging of the liver that showed the vascular nature of the lesions. Fig.…”
Section: Case Reportmentioning
confidence: 55%
“…In 2018, Liu et al. Little presented two cases of isolated hepatic hemangiomatosis, and included a review of 15 other cases of isolated hepatic hemangiomatosis reported in English literature from 1970 up to that moment (July 2018) [6] .…”
We report a case of hepatic hemangiomatosis coexistent with a giant hepatic hemangioma diagnosed in the context of the study for SARS-CoV-2 infection. Computed tomography showed irregular contours of the left hepatic lobe with a lesion that compromised the whole lobe, with peripheral uptake and a centripetal tendency in the late phase, compatible with bulky cavernous hemangioma, as well as another lesion with the same characteristics in segment VI. Magnetic resonance imaging of the abdomen showed multiple hepatic hemangiomas observed in both lobes involving all segments, some of them smaller than 1 cm, which were hyperintense in the T2-weighted sequences and showed progressive contrast enhancement. This case illustrates the incidental diagnosis of this condition during the study for another pathology, the radiological features that are important to differentiate from other tumoral findings, and the possible management strategies to follow.
“…3 ). These characteristics were consistent with the diagnosis of liver hemangiomatosis [6] and biopsy was not performed due to the absence of chronic liver disease, normal laboratory tests and the evaluation of the imaging of the liver that showed the vascular nature of the lesions. Fig.…”
Section: Case Reportmentioning
confidence: 55%
“…In 2018, Liu et al. Little presented two cases of isolated hepatic hemangiomatosis, and included a review of 15 other cases of isolated hepatic hemangiomatosis reported in English literature from 1970 up to that moment (July 2018) [6] .…”
We report a case of hepatic hemangiomatosis coexistent with a giant hepatic hemangioma diagnosed in the context of the study for SARS-CoV-2 infection. Computed tomography showed irregular contours of the left hepatic lobe with a lesion that compromised the whole lobe, with peripheral uptake and a centripetal tendency in the late phase, compatible with bulky cavernous hemangioma, as well as another lesion with the same characteristics in segment VI. Magnetic resonance imaging of the abdomen showed multiple hepatic hemangiomas observed in both lobes involving all segments, some of them smaller than 1 cm, which were hyperintense in the T2-weighted sequences and showed progressive contrast enhancement. This case illustrates the incidental diagnosis of this condition during the study for another pathology, the radiological features that are important to differentiate from other tumoral findings, and the possible management strategies to follow.
“…Hepatic hemangiomatosis is an uncommon disorder characterized by the proliferation of numerous hepatic hemangiomas dispersed throughout the liver parenchyma. Although typically asymptomatic in adults, hemangiomatosis is more commonly observed in newborns, where it can be associated with congestive heart failure [ 56 , 57 ]. Unlike the presentation of multiple discrete hepatic hemangiomas, hemangiomatosis features lesions that are ill-defined, extensive, and confluent, potentially encompassing the majority of the hepatic parenchyma.…”
Section: Atypical Hepatic Hemangiomas In Imagingmentioning
confidence: 99%
“…However, MRI retains its diagnostic utility in these cases, as T1- and T2-weighted sequences reveal distinctive signal patterns. Despite heterogeneous enhancement in the arterial phase, these lesions demonstrate progressive enhancement in dynamic late phases, maintaining typical signal intensities on T1- and T2-weighted MR sequences [ 43 , 46 , 56 , 57 ].…”
Section: Atypical Hepatic Hemangiomas In Imagingmentioning
Hepatic hemangiomas are the most common benign liver tumors. Typically, small- to medium-sized hemangiomas are asymptomatic and discovered incidentally through the widespread use of imaging techniques. Giant hemangiomas (>5 cm) have a higher risk of complications. A variety of imaging methods are used for diagnosis. Cavernous hemangioma is the most frequent type, but radiologists must be aware of other varieties. Conservative management is often adequate, but some cases necessitate targeted interventions. Although surgery was traditionally the main treatment, the evolution of minimally invasive procedures now often recommends transarterial chemoembolization as the treatment of choice.
“…Thus, the natural history of hepatic hemangiomatosis is also important in determining a treatment for hepatic hemangioma. However, the natural history of hepatic hemangiomatosis remains largely unknown [ 18 , 19 ]. This study aimed to evaluate the natural history of hepatic hemangiomas >10 cm in size.…”
Introduction: The natural history of a large hepatic hemangioma is important in determining the treatment strategy. Although several studies have assessed the natural history of hepatic hemangiomas, no study has focused on hepatic hemangiomas measuring >10 cm. The aim of this study was to assess the natural history of hepatic hemangiomas measuring >10 cm by evaluating imaging findings and clinical course.
Methods: Computed tomography (CT) and magnetic resonance imaging (MRI) reports at Kyoto University Hospital, Kyoto, Japan, between January 2001 and March 2023 were retrospectively searched to find adult patients with hepatic hemangiomas >10 cm. Patients who were followed up without treatment for over six months were included. The maximum diameter of the hepatic hemangioma was compared between the baseline and the final CT or MRI. The clinical course of the patients was evaluated.
Results: Twenty-two patients (17 women, five men; median age, 51 years) were identified. The median diameter of hepatic hemangiomas in the baseline study was 114 mm. Two patients had abdominal distention at the time of the baseline imaging, whereas the others were asymptomatic. After follow-up without treatment (the median; 95.5 months), enlargement, no change, shrinkage of hepatic hemangioma was observed in six, 11, and five patients, respectively. The median growth rate of hepatic hemangiomas was 2.5 mm/year. Two patients underwent liver resection for hepatic hemangioma, while the others were followed up without treatment. In four patients, symptoms appeared or worsened. Two patients died: one patient died from prostate cancer progression; the cause of death for the other was not confirmed.
Conclusion: Hepatic hemangiomas show a slow growth rate during follow-up, and shrinkage is occasionally observed. Some patients experience new symptoms or aggravation of symptoms; however, deaths associated with hepatic hemangiomas are uncommon.
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