Hepatic hemangioma Health Article

Definition

A hepatic hemangioma is a noncancerous liver tumor made of dilated blood vessels.

Alternative Names

Liver hemangioma; Hemangioma of the liver; Cavernous hepatic hemangioma; Infantile hemangioendothelioma; Multinodular hepatic hemangiomatosis

Causes, incidence, and risk factors

A hepatic hemangioma is the most common noncancerous tumor of the liver. It is believed to be a birth defect, and is usually not discovered until medical pictures are taken of the liver for some other reason.

Hepatic hemangiomas can occur at anytime, but are most common in the 30s to 50s. Women are affected more often than men, and usually have bigger tumors than men.

Babies may develop a type of hepatic hemangioma called benign infantile hemangioendothelioma (also called multinodular hepatic hemangiomatosis). This rare, noncancerous tumor has been linked to high rates of heart failure and death in infants. Infants are usually diagnosed by the time they are 6 months old.

Symptoms

Hemangiomas may cause bleeding or interfere with organ function, depending on their location. Most cavernous hemangiomas do not show symptoms. In rare cases, a cavernous hemangioma may rupture. (The only symptom may be an enlarged liver.)

Babies with benign infantile hemangioendothelioma may have an abdominal mass, anemia, and signs of heart failure.

Signs and tests

The following tests may be performed:

• Single-photon emission computed tomography (SPECT)
• MRI
• CT scan of the liver
• Hepatic angiogram
• Blood tests (thrombocytopenia may be present in large hemangiomas)

Treatment

Most cavernous hepatic hemangiomas are treated only if there is persistent pain.

Treatment for infantile hemangioendothelioma depends on the child's growth and development. The following treatments may be needed:

• Medications for heart failure
• Embolization of the liver
• Ligation of the liver artery
• Surgery to remove the tumor

Expectations (prognosis)

In infants whose tumor is only in one lobe of the liver, surgery is a cure, even if the child has heart failure.

Complications

Pregnancy and estrogen-based medications can cause cavernous hemangiomas to grow.

References

Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. 7th ed. Philadelphia, PA: WB Saunders; 2002:1592-1594.

Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 7th ed. St. Louis, Mo; WB Saunders; 2005: 562.