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Hepatic hemangioma
Definition
A hepatic hemangioma is a noncancerous liver tumor made of widened (dilated) blood vessels.
Alternative Names
Liver hemangioma; Hemangioma of the liver; Cavernous hepatic hemangioma; Infantile hemangioendothelioma; Multinodular hepatic hemangiomatosis
Causes
A hepatic hemangioma is the most common noncancerous tumor of the liver. It is believed to be a birth defect.
Hepatic hemangiomas can occur at any time, but are most common in people in their 30s - 50s. Women are affected more often than men, and usually have bigger tumors than men.
Babies may develop a type of hepatic hemangioma called benign infantile hemangioendothelioma (also called multinodular hepatic hemangiomatosis). This rare, noncancerous tumor has been linked to high rates of heart failure and death in infants. Infants are usually diagnosed by the time they are 6 months old.
Symptoms
Some hemangiomas may cause bleeding or interfere with organ function, depending on their location. Most cavernous hemangiomas do not produce symptoms. In rare cases, a cavernous hemangioma may rupture.
Exams and Tests
Hepatic hemangioma is usually not discovered until medical pictures are taken of the liver for some other reason. If a cavernous hemangioma ruptures, the only sign may be an enlarged liver.
Babies with benign infantile hemangioendothelioma may have:
- A growth in the abdomen
- Anemia
- Signs of heart failure
The following tests may be performed:
- Blood tests
- CT scan of the liver
- Hepatic angiogram
- MRI
- Single-photon emission computed tomography (SPECT)
- Ultrasound of the abdomen
Treatment
Most cavernous hepatic hemangiomas are treated only if there is persistent pain.
Treatment for infantile hemangioendothelioma depends on the child's growth and development. The following treatments may be needed:
- Inserting a material in a blood vessel of the liver to block it (embolization)
- Tying off (ligation) a liver artery
- Medications for heart failure
- Surgery to remove the tumor
Outlook (Prognosis)
In infants whose tumor is only in one lobe of the liver, surgery is a cure, even if the child has heart failure.
Possible Complications
Pregnancy and estrogen-based medications can cause cavernous hemangiomas to grow.
References
DiBisceglie AM, Befeler AS. Tumors and cysts of the liver. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 94.
Roberts LR. Liver and biliary tract tumors. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 206.
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
