Hepatic Hemangioma

A young woman had a liver mass resected. The lesion was diagnosed as a cavernous hemangioma of the liver (Figure 1). What statement is most accurate about liver hemangioma? a.Hepatic hemangiomas are common benign liver tumors.b.Hepatic hemangiomas are exceptionally rare benign liver tumors.c.Hepatic hemangiomas are rarely discovered incidentally.d.Hepatic hemangiomas most often occur in elderly men. Answer: a. Hepatic hemangiomas are common benign liver tumors. A spectrum of vascular lesions can occur in the liver, from hemangiomas to hepatic epithelioid hemangioendothelioma and angiosarcoma. Unlike hepatic epithelioid hemangioendothelioma and angiosarcoma, hepatic hemangiomas are benign tumors. Hepatic hemangiomas are common benign liver tumors.1Choi B.Y. Nguyen M.H. The diagnosis and management of benign hepatic tumors.J Clin Gastroenterol. 2005; 39: 401-412Crossref PubMed Scopus (16) Google Scholar Although hepatic hemangiomas are often identified incidentally, they can be associated with pain or compressive symptoms and rarely bleeding and rupture, and they can be associated with Kasabach-Merritt syndrome.2Aziz H. Brown Z.J. Baghdadi A. Kamel I.R. Pawlik T.M. A comprehensive review of hepatic hemangioma management.J Gastrointest Surg. 2022; 26: 1998-2007Crossref Scopus (2) Google Scholar Hepatic hemangiomas most commonly affect women and are often identified in individuals 30 to 50 years of age but can occur over a wide age range, including in children.3Ajay P.S. Tsagkalidis V. Casabianca A. et al.A review of hepatic epithelioid hemangioendothelioma—analyzing patient characteristics and treatment strategies.J Surg Oncol. 2022; 126: 1423-1429Crossref Scopus (2) Google Scholar Hepatic hemangiomas have a spongy, honeycomb texture grossly and may have firm white areas if they thrombose and have sclerosis (Figure 1). On histologic evaluation, most hepatic hemangiomas are cavernous hemangiomas with cavernous vascular channels with fibrous stroma lined by a single layer of endothelial cells (Figures 2 and 3).Figure 3Cavernous hemangioma of the liver composed of endothelial cell–lined blood-filled spaces.View Large Image Figure ViewerDownload Hi-res image Download (PPT)