Although many people refer to them as tumors, hemangiomas are not malignant and do not become cancerous. There is no evidence to suggest that people who do not treat a liver hemangioma can develop liver cancer. Liver hemangiomas are the most common type of benign liver tumor. They are not cancerous. Liver hemangiomas rarely cause complications, although larger or multiple hemangiomas can cause painful or uncomfortable symptoms.
If someone suspects that they have a liver hemangioma, they should speak to a doctor about the best ways to diagnose and manage the condition. Liver transplant surgery is the second most common transplant surgery in the U. Livers typically come from deceased donors, but transplants using…. The liver has many roles, one being to make cholesterol while another is to remove excess amounts. Healthy cholesterol levels are essential for the…. Pain in the upper abdomen on the right side may be due to a liver problem.
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An ultrasound scan uses high-frequency sound waves to create an image of the inside of the body. It is safe to use during pregnancy and is also a…. What to know about liver hemangiomas. Medically reviewed by Saurabh Sethi, M. What is it? What is a hemangioma of the liver? Furthermore, Reasons for obtaining the initial image included abdominal pain The initial mean SD linear dimension of the hemangiomas was 3. Of the hemangiomas followed up, 83 Similarly, of hemangiomas with volumetric measurements, 72 Similarly, 64 The overall change in mean SD linear dimension for all lesions during the follow-up period was 0.
Similarly, the overall change in volume was Furthermore, this subset of lesions is thought to have exhibited an actual change in size rather than being a result of simple measurement variability. This subset of lesions exhibited overall growth in mean linear dimension by 0. Similarly, this group of lesions had an overall volume change of A strong correlation was demonstrated between initial mean linear dimension and hemangioma growth.
Furthermore, even when examined as the percentage of growth, larger lesions showed significantly more growth with time. Of hemangiomas with an initial mean linear dimension of less than 3 cm, only 46 The overall and annual mean SD growth rates for lesions with an initial mean linear dimension of 3 cm or less were 0. For lesions with an initial mean linear dimension of 5 cm or less, the overall and annual growth rates were 1.
A similar pattern was seen when measured by volumes. During the study period, hemangiomas appeared to grow in a uniform fashion as a function of time.
The traditional teaching has been that most hepatic hemangiomas remain constant in size over time. Specifically, A number of small series have reported some growth in hepatic hemangiomas over time. First, in several previous studies, only symptomatic patients were reimaged, increasing the population for larger hemangiomas.
Second, we included all patients with hemangiomas larger than 1 cm who had at least 1 year of follow-up, thereby capturing more points in time. Finally, most prior studies relied almost solely on ultrasound imaging, with which reproducible measurement is much more difficult and user dependent. Furthermore, in some series, larger lesions were excluded owing to difficulty in obtaining accurate measurements, thus eliminating the lesions in which we identified the highest growth rates.
To our knowledge, this study is the first to use advanced cross-sectional imaging computed tomography or magnetic resonance imaging alone to describe the growth rate of hemangiomas during long-term follow-up. Use of advanced cross-sectional imaging allows not only for more precision in diagnosis but also for a more reliable means of assessment of growth, as the lesions can be measured in a defined plane and compared directly on follow-up studies.
As a result, this study is the first to examine change in hemangioma volume, which is the most accurate measure of hemangioma size. While an understanding of the fraction of hemangiomas that grow is important, knowing the normal rate of growth is necessary for clinical utility. Given that these lesions are frequently detected incidentally and then followed up inadvertently as serial images are obtained for another indication, such as cancer surveillance, it is essential to understand what change in hemangioma size is considered to be outside the normal range.
Furthermore, we found that the initial mean linear dimension predicts the overall and annual growth rate. Hemangiomas less than 3 cm in mean linear dimension have an annual growth rate of only 0. Although there are no convincing data to guide clinical treatment for patients with growing hemangiomas, it is clear that hemangioma growth currently leads surgeons to consider resection.
This outcome is well demonstrated by a recent multicenter study of patients who received resection of hepatic hemangiomas. Therefore, defining expected growth rates should help guide radiographic interpretation of serial imaging in patients with hepatic hemangiomas.
Although this study cannot address the clinical significance of growth outside the range expected for a population of patients with hemangiomas, it provides boundaries that can be used to define outliers. Further long-term prospective evaluation of patients who present with growth beyond what is expected is needed to determine how this growth should affect clinical decision making. This information has the potential to decrease the number of operative resections performed because of hemangioma growth.
Although this is one of the largest studies to report the long-term radiographic follow-up of hepatic hemangiomas, it also has several limitations. First, the data were collected from an imaging database retrospectively, thereby limiting the amount of associated clinical information available.
Second, although the follow-up period was long compared with other articles, it is still relatively short when compared with the life of the patient.
Perhaps when followed up for many decades, both the fraction of hemangiomas that grow and the rate of growth would differ from those of this study. Finally, we examined only the first and last imaging study for each patient to allow for maximal change in size. It is possible that there were greater fluctuations in size on scans done in the interval that were missed with this strategy.
A normal range for overall and annual growth rates should prove helpful in the clinical setting for deciding which lesions are outliers.
Further research is required to determine the clinical significance of the growth of hemangiomas for patients with growth rates outside the range defined by this study. Corresponding Author: Hani Y. Published Online: October 15, Author Contributions: Dr Hasan had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Critical revision of the manuscript for important intellectual content: Hasan, Hinshaw, Borman, Leverson.
Conflict of Interest Disclosures: None reported. Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy Continue. Figure 1. Volumetric Measurement of Hepatic Hemangioma. View Large Download. Figure 2. Figure 3. Table 1. Patient Demographics and Baseline Measurements. A liver hemangioma is made up of a tangle of blood vessels. Other terms for a liver hemangioma are hepatic hemangioma and cavernous hemangioma.
Most cases of liver hemangiomas are discovered during a test or procedure for some other condition. People who have a liver hemangioma rarely experience signs and symptoms and typically don't need treatment. It may be unsettling to know you have a mass in your liver, even if it's a benign mass.
There's no evidence that an untreated liver hemangioma can lead to liver cancer. A liver hemangioma is a noncancerous benign mass in the liver. However, these symptoms are nonspecific and may be due to something else, even if you have a liver hemangioma.
Make an appointment with your doctor if you experience any persistent signs and symptoms that worry you. The liver is your largest internal organ. About the size of a football, it's located mainly in the upper right portion of your abdomen, beneath the diaphragm and above your stomach. It's not clear what causes a liver hemangioma to form. Doctors believe liver hemangiomas are congenital — meaning that you're born with them. A liver hemangioma usually occurs as a single abnormal collection of blood vessels that is less than about 1.
Occasionally liver hemangiomas can be larger or occur in multiples. Large hemangiomas can occur in young children but this is very rare. In most people, a liver hemangioma will never grow and never cause any signs and symptoms. But in a small number of people, a liver hemangioma will grow to cause complications and require treatment.
It's not clear why this happens. Factors that can increase the risk that a liver hemangioma will cause signs and symptoms include:. Women who have been diagnosed with liver hemangiomas face a risk of complications if they become pregnant. The female hormone estrogen, which increases during pregnancy, is believed to cause some liver hemangiomas to grow larger. Rarely, growing hemangioma can cause signs and symptoms that may require treatment, including pain in the upper right quadrant of the abdomen, abdominal bloating or nausea.
Having a liver hemangioma doesn't mean you can't become pregnant. However, discussing the possible complications with your doctor can help you make a more informed choice. Medications that affect hormone levels in your body, such as birth control pills, could cause complications if you've been diagnosed with a liver hemangioma.
But this is controversial. If you're considering this type of medication, discuss the benefits and risks with your doctor. If your liver hemangioma is small and doesn't cause any signs or symptoms, you won't need treatment. In most cases a liver hemangioma will never grow and will never cause problems. Your doctor may schedule follow-up exams to check your liver hemangioma periodically for growth if the hemangioma is large.
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