Surgical Management for Giant liver Hemangiomas Greater Than 20 cm in Size

Abstract

Background/AimsThe aim of this study was to investigate the primary management experience for giant liver hemangiomas greater than 20 cm in size.MethodsRecords of patients referred for evaluation of radiologically and/or histopathologically proven giant liver hemangiomas between January 2007 and March 2010 were retrospectively analyzed. The reasons for referral, results of imaging studies, preoperative and surgical treatments, and outcome were reviewed.ResultsA retrospective analysis was performed for 14 patients diagnosed with a giant hemangioma on the basis of an imaging study and/or a histopathological examination. All cases were diagnosed as giant liver hemangioma with at least one lesion greater than 20 cm in size. Abdominal discomfort was the main presenting complaint for the referral in 9 patients (64.2%). Abdominal ultrasound established the diagnosis in 12 patients (85.7%). Twelve patients underwent liver resection, 2 of whom underwent staged resection. Enucleation was performed in 2 patients. Selective transcatheter arterial embolization was implemented in 9 patients. Postoperative morbidity occurred in 3 patients (21.4%). No complications related to the hemangiomas occurred during follow up.ConclusionsLiver resection is indicated for giant liver hemangiomas with abdominal discomfort, especially for lesions greater than 20 cm in size. Staged operations are performed for patients with multiple lesions. Preoperative selective transcatheter arterial embolization alleviates progressive abdominal pain.

Benign Liver Lesions: AClinical Profile

“…[3] In study done by Sharma et al, mean age was 40 years. [5] Similar findings were also observed in study done by Rajak et al, in which average age was 35 years. [6] In our study out of 25 cases of amoebic liver abscess 18 (72%) cases were from rural area (Table 4), which is in accordance with study done by Mathur et al [2] In our study 5 (20%) cases of amoebic liver abscess were alcoholic (Table 5), which is in contrast to study done by Mathur et a1 and Seeto et al, in which 70% and 43% cases were alcoholic.…”

“…[3] In our study USG findings showed hypoechoic lesion in all cases, hepatomegaly in 11 (44%) cases, right lobe was involved in 22 (88%) cases, left lobe in 2 (8%) cases, both lobes in 1 (4%) case, single lesion in 21 (81%) cases and multiple lesion in 4 (16%) cases of amoebic liver abscess. Similar findings were observed in study done by Seeto et al, Mathur et al and Sharma et al [2][3] [5] In our study USG guided aspiration was done in 14 cases of amoebic liver abscess, out of which 10 (52.6%) cases demonstrated tropozoite of E.histolytica on microscopy which is in contrast to study done by Haque et al and Seeto et al in which tropozoite were demonstrated in 11% and 4% cases respectively. [3][8]…”

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.…”

“…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. 2,3,10 Because most hepatic hemangioma are asymptomatic, they are often recognized incidentally during radiologic tests for other reasons. However, in some patients the location and size of the lesion can cause various signs and findings.…”

“…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.…”