Ultrasonography.  2014 Jan;33(1):65-70.

Giant cavernous hemangioma coexistent with diffuse hepatic hemangiomatosis presenting as portal vein thrombosis and hepatic lobar atrophy

• Yoo BR
• Han HY
• Choi SY
• Kim JH

Abstract

A combination of giant hepatic hemangioma and diffuse hemangiomatosis is extremely rare in adults. Even when they are large, hemangiomas are soft and rarely compress adjacent structures. A 78-year-old man presented with abdominal pain and distension. Ultrasonography, computed tomography, and magnetic resonance imaging demonstrated a large expansile mass replacing the medial segment and caudate lobe with diffusely scattered nodules in the entire liver. The large hilar mass contained a central nonenhancing area and had a mass effect, leading to left portal vein occlusion. The image findings also revealed two unprecedented findings: left lateral segmental atrophy of the liver and recent portomesenteric vein thrombosis. The hepatic lesions were confirmed with hemangiomas by ultrasonography-guided biopsy. We diagnosed intrahepatic portal vein obstruction caused by a mass effect of giant hepatic hemangioma coexistent with diffuse hemangiomatosis, resulting in hepatic segmental atrophy and extrahepatic portal vein thrombosis.

Keyword

Liver; Hemangioma; Portal vein; Thrombosis; Atrophy

MeSH Terms

Abdominal Pain
Adult
Aged
Atrophy*
Biopsy
Hemangioma
Hemangioma, Cavernous*
Humans
Liver
Magnetic Resonance Imaging
Portal Vein*
Thrombosis
Ultrasonography
Veins
Venous Thrombosis*