Resection of a rapid-growing 40-cm giant liver hemangioma

Abstract

Hemangiomas are the most frequent benign tumors of the liver. Most hemangiomas are asymptomatic and therefore largely diagnosed only in routine screening tests. Usually they are small and require no specific treatment. In some situations they can reach great dimensions, causing some discomfort to the patient. Resection of liver hemangioma is indicated in cases of great dimension tumors causing symptoms such as pain, nausea or bloating caused by compression of adjacent organs. We report a case of a rare giant hemangioma with rapid growth in short time: a 50 year old female reported to our institution with a 40 cm giant liver hemangioma and then underwent a left hepatectomy.

Giant Hepatic Hemangioma Presenting as Gastric Outlet Obstruction

“…[9][10][11] The incidence of hemangiomas varies from 0.4% to 20%. [1][2][3]6 Hemangioma are often seen between the ages of 30 and 50 years and 5 to 6 times more often in women than in men. 4,6,7,9,10 Therefore, it has been suggested that there may be a relationship between the disease and the use of exogenous steroids or female-specific hormones, although the relationship has not been clearly shown.…”

“…Most lesions are less than 3 cm and a significant proportion of patients are asymptomatic. [1][2][3][4] In symptomatic patients, symptoms are associated with the size and location of the lesion, such as nausea, vomiting, abdominal pain, palpable mass, obstructive jaundice, gastric outlet obstruction and hemorrhage, consumption coagulopathy, and thrombocytopenia, which are characteristic of Kasabach-Merritt syndrome. 1,2,5 Although there is no general consensus on size, hemangioma .4 cm are referred to as giant.…”

“…[1][2][3][4] In symptomatic patients, symptoms are associated with the size and location of the lesion, such as nausea, vomiting, abdominal pain, palpable mass, obstructive jaundice, gastric outlet obstruction and hemorrhage, consumption coagulopathy, and thrombocytopenia, which are characteristic of Kasabach-Merritt syndrome. 1,2,5 Although there is no general consensus on size, hemangioma .4 cm are referred to as giant. 1,2,[5][6][7][8] In asymptomatic patients, although there is agreement that there should be close monitoring rather than any treatment, at present there has been no consensus as to whether medical treatment, interventional radiologic treatment, or surgical treatment should be applied to symptomatic cases.…”

“…1,2,5 Although there is no general consensus on size, hemangioma .4 cm are referred to as giant. 1,2,[5][6][7][8] In asymptomatic patients, although there is agreement that there should be close monitoring rather than any treatment, at present there has been no consensus as to whether medical treatment, interventional radiologic treatment, or surgical treatment should be applied to symptomatic cases. This study aimed to present an approach to a case of giant hepatic hemangioma that developed in the left lobe of the liver with findings of gastric outlet obstruction.…”

Bilateral Lower Limb Edema Caused by Compression of the Retrohepatic Inferior Vena Cava by a Giant Hepatic Hemangioma

“…1 In a very small minority of patients, signs and symptoms including nausea, vomiting, abdominal pain, palpable mass, obstructive jaundice, bleeding, Budd-Chiari syndrome, and edema and deep vein thrombosis in the lower limbs develop due to compression of the bile duct, hepatic vein, portal vein, inferior vena cava, or gastrointestinal system organs. [4][5][6][7][8] The most important factors contributing to these symptoms are the size, growth rate, and localization of the hemangioma in the liver. To our knowledge, only one case of liver hemangioma has been published so far that has reported edema and deep vein thrombosis of the lower limbs resulting from compression of the retrohepatic inferior vena cava.…”