Hepatic Hemangioma

Hepatic hemangiomas are thought to be present in as many as 7% of healthy people. Hemangiomas are four to six times more common in women than in men. Female hormones may promote the formation and growth of hemangiomas. Hemangiomas, although referred to as tumors, are not malignant and do not become cancerous. Hemangiomas are not unique to the liver and can occur almost anywhere in the body.

Hemangiomas usually are small, measuring only a quarter inch in diameter, but they can be several inches in diameter or even larger. The vast majority of hemangiomas of the liver never cause symptoms or health problems. Most hepatic hemangiomas are discovered incidentally at the time of testing for unrelated medical problems, most commonly with ultrasound imaging or CT (computerized tomography) scanning of the abdomen. Very large hemangiomas can cause symptoms, especially if they are positioned near other organs. Pain, nausea, or enlargement of the liver can occur. Rarely, larger hemangiomas can rupture, causing severe pain and bleeding into the abdomen that may be severe or even life threatening.

When a hemangioma is suspected, the challenge for the health care professional, is to be sure that it is in fact a hemangioma and not another type of tumor, particularly a malignant one. With specialized tests, however, doctors can reassure patients that the tumor is with little doubt a hemangioma. Such special testing may include scintigraphy (using a tiny amount of a radioactive substance to identify the hemangioma), CT scanning, or MRI (magnetic resonance imaging). In general, a biopsy of suspected hemangiomas is avoided because of their benign nature and the potential risk of bleeding from the biopsy.

The vast majority of hepatic hemangiomas require no treatment. If a hepatic hemangioma is large, especially if it is causing symptoms, surgical removal is an option.