Hepatic hemangioma

What is a hepatic hemangioma?

The term hemangioma describes a benign tumor of blood vessels. It involves excessive growth of the inner lining of the blood vessels affected. If this type of tumor is present in the liver, it is known as hepatic hemangioma. Actually, this is the most common form of benign liver tumor.

Causes of hepatic hemangioma

It is still unclear what causes hepatic hemangioma formation. Potential growth factors promoting the development of hepatic hemangiomas are considered to be oral contraceptive use or pregnancy. Although, it is still uncertain as to how these hormones influence the growth of a hemangioma.

Symptoms and diagnosis of hepatic hemangiomas

Most hepatic hemangiomas lack symptoms and therefore remain hidden for years. In most locations, a diagnosis is established by accident, such as when a liver ultrasound is performed for other purposes. Also, a CT or MRI scan with contrast may visualize a hepatic hemangioma. On rare occasions, though, hepatic hemangiomas of large size can burst due to sustained growth, resulting in bleeding into the abdominal cavity.

Surgery for hepatic hemangioma

In the majority of cases, therapy or regular monitoring of a hepatic hemangioma is not required. Only if the more hemangiomas are present or its volume is very large, your doctor may order periodic imaging to monitor its progress. Surgery is indicated if a hemangioma causes complaints, grows rapidly, or has a diameter of more than 10 cm. Prior to surgery, the nature of abdominal pain must be carefully investigated to make sure it is not due to another cause.

Two options are available for surgery of hepatic hemangioma. Firstly, a so-called enucleation can be performed. In this procedure, the hemangioma is removed along with its capsule. The other option is partial liver resection, meaning that adjacent liver tissue is resected along with the hemangioma. According its location and size, the hemangioma can be removed either by minimally invasive keyhole technique or by means of surgery with opening of the abdominal cavity. Both methods carry a risk for potential bleeding during surgery, as blood vessels are being removed which may have a significant blood supply. After the operation, the patients are being monitored in the intensive care unit until risk of postoperative bleeding has passed.

Can liver hemangiomas turn malignant?

For any benign tumor, the theoretical possibility of it turning into a malignant cancer is present. In the case of hepatic hemangiomas, however, this risk is very small. Nevertheless, should rapid growth, pain or other abnormalities develop, patients are advised to consult a doctor.

Which doctors and clinics specialize in hepatic hemangioma surgery?

Gastroenterologists are the experts for hepatic hemangiomas. In the event that surgery is needed, patients can consult visceral surgeons, who focus on hepatobiliary surgery. In hospitals, doctors of these two specialties cooperate to determine the optimal course of treatment for the patient on an individual basis.

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