Benign Vascular Hepatic Tumor

Kim, Do Young

Abstract

Hemangioma is the most common type of benign vascular hepatic tumor. It is more prevalent in women with a 5:1 female: male ratio with a mean age of 50 years. Symptoms related to hemangiomas are mostly absent even in giant (> 10 cm) ones. The most feared complication of hemangioma is abdominal hemorrhage caused by rupture, the risk of which is nearly zero for hemangiomas < 5 cm and rupture rarely occurs even in patients with giant hemangiomas. The diagnosis of hemangioma depends on the findings in imaging modalities such as US, dynamic computed tomography (CT), and magnetic resonance imaging (MRI). The typical features of hemangiomas in US are well-circumscribed hyperechoic nodule, iso- or hypoechoic nodule with hyperechoic rim. In a liver with underlying fatty change, hemangioma may appear as a hypoechoic nodule. It is necessary to proceed on other high-resoultion modality (CT or MRI) if the finding in US is atypical or the patient has chronic liver disease. The characteristics of hemangiomas in CT or MRI is peripheral globular enhancement with centripetal progression and persistence of enhancement in delayed phase. Although it is controversial, follow-up with annual US scans is advised for the newly diagnosed hemangiomas.