Transcatheter Arterial Embolization Alone for Giant Hepatic Hemangioma

Abstract

Giant hepatic hemangioma is a benign liver condition that may be treated using surgery. We studied the digital subtraction angiographic (DSA) characteristics of giant hepatic hemangioma, and the effectiveness of transcatheter arterial embolization (TAE) alone for its treatment. This was a retrospective study of 27 patients diagnosed with giant hepatic hemangioma and treated with TAE alone (using lipiodol mixed with pingyangmycin) at the Division of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University, between January 2010 and March 2013. The feeding arteries were identified using DSA. All patients were followed up for between three weeks and 12 months. Changes in tumor diameter and symptoms were observed. The 27 patients included had giant hepatic hemangiomas ranging from 5.3 to 24.5 cm (mean, 11.24±5.08 cm) in the right (n = 13), left (n = 1) or both (n = 13) lobes. Preoperative hepatic angiography showed multiple abnormal vascular lakes in the early phase, known as the “early leaving but late returning, hanging nut on a twig” sign. On the day after TAE, hepatic transaminase levels were increased (ALT: 22.69±17.95 to 94.88±210.32 U/L; ALT: 24.00±12.37 to 99.70±211.54 U/L; both P<0.05), but not total bilirubin. Six patients complained of abdominal pain, and 12 experienced transient fever. In the months after TAE, tumor size decreased (baseline: 11.24±5.08; 3 months: 8.95±4.33; 6 months: 7.60±3.90 cm; P<0.05), and the patients’ condition improved. These results indicated that TAE was effective and safe for treating giant hepatic hemangioma. TAE may be a useful alternative to surgery for the treatment of hepatic hemangioma.

Hepatic artery embolization for treating giant hemangioma of liver: an experience from a tertiary level hospital in India

“…On long term follow up, abscess formation occurred in 1 patient. Immediate complication rate 46% in present study which is comparable with study done by Sun J-H et al 10 Srivastava DN et al, Deutsch GS et al and Mohan S et al studied that TAE is safe and effective therapy for haemangiomas, however no significant change in tumour size noted. [13][14][15] Zeng Q et al , Firouznia K et al and Panis Y, et al found that significant reduction in tumour size of all patients and symptomatic relief in almost all patients.…”

“Double Trouble”: Preoperative Embolization in a Case of Double Rupture of Hepatic Hemangioma during Pregnancy

“…Various embolic agents can be used including PVA particles, gel foam slurry, iso-butyl cyanoacrylate, and coils mainly. 10 Because of its permanent embolic nature, PVA particle was considered as an embolic of choice in our case. [9][10][11] A review of the literature has revealed only a few cases of pregnancy associated with a complicated hemangioma.…”

The Effect of Bleomycin Embolization on Symptomatic Improvement and Hemangioma Size among Patients with Giant Liver Hemangiomas

“…Cavernous hemangiomas are the most common type of benign tumors of the liver [1] [4]. Most are small, asymptomatic and detected incidentally by radiological screening [5]. Giant cavernous hemangiomas may cause symptoms such as pain, abdominal sense of fullness, and upper abdominal mass.…”