Hemangioma of the liver

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Hemangioma of the liver, also liver hemangioma and hepatic hemangioma, is a benign vascular tumour of the liver, that may be mistaken for metastatic disease.[1]

Hemangioma of the liver
Diagnosis in short

Cavernous liver hemangioma. H&E stain.
LM DDx epithelioid hemangioendothelioma, angiosarcoma, metastatic disease
Site liver

Clinical history often an incidental finding
Symptoms +/-upper abdominal pain
Radiology well circumscribed mass
Prognosis benign
Clin. DDx metastatic disease
Treatment usually follow-up, non-conservative if very large

Hemangiomas, more generally, are dealt with in the hemangioma article.

General

  • Benign.[2]
    • Can be hard to differentiate from metastatic disease on imaging.[1]
  • Usually an incidental finding (incidentaloma) and often asymptomatic.[2]
  • Large lesions may present with upper abdominal pain.
  • May cause congestive heart failure in infants - if large.[3]

Clinical:

  • Do not grow in size - can be followed if small or medium size (<10 cm).[2]

Gross

  • Variable size.
  • Well circumscribed.

Microscopic

Features:

  • Channels lined by benign endothelium containing RBCs.

DDx:

Images

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Liver Lesion, Core Biopsy:
- Cavernous hemangioma.
- NEGATIVE for malignancy.

Micro

The sections show dilated vascular spaces containing red blood cells that are lined by endothelial cells without significant atypia. The vascular spaces are separated by bland fibrous tissue.

Abnormal perivascular cells are not identified. The background liver is without atypia and does not have appreciable fat.

See also

References

  1. 1.0 1.1 Yamashita, Y.; Shimada, M.; Taguchi, K.; Gion, T.; Hasegawa, H.; Utsunomiya, T.; Hamatsu, T.; Matsumata, T. et al. (2000). "Hepatic sclerosing hemangioma mimicking a metastatic liver tumor: report of a case.". Surg Today 30 (9): 849-52. PMID 11039718.
  2. 2.0 2.1 2.2 Bajenaru, N.; Balaban, V.; Săvulescu, F.; Campeanu, I.; Patrascu, T. (2015). "Hepatic hemangioma -review.". J Med Life 8 Spec Issue: 4-11. PMID 26361504.
  3. Kayaalp, C.; Sabuncuoglu, MZ. (Aug 2015). "Embolization of Liver Hemangiomas.". Hepat Mon 15 (8): e30334. doi:10.5812/hepatmon.30334. PMID 26322113.