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Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Hepatic hemangioma natural history, complications and prognosis

Introduction

Overview

Overview

If left untreated, patients with giant hepatic hemangiomas may progress to develop complications. Complications of hepatic hemangioma include spontaneous rupture, acute hemorrhagic shock, and upper abdominal pain.[1][2] Prognosis is generally excellent, and the mortality rate of patients with spontaneous rupture of hepatic hemangioma is approximately 30-40%.[2]

Natural history

Natural history

  • Most of the hepatic hemangiomas are characterized by benign uncomplicated course and most lesions are asymptomatic.[3]
  • Hepatic hemangioma is the most common benign liver tumor and typically remains stable in size.[4]
  • These are usually diagnosed as asymptomatic incidental findings.
  • Hemangiomas also (rarely) rupture spontaneously or by trauma and then lead to acute hemorrhagic shock with upper abdominal pain.[1][2]
  • In the worldwide literature a total of only 97 cases with a rupture of a hemangioma have been published, whereas a spontaneous rupture only happened in 47.4% of cases.[5][2]
  • Hemangiomas generally have no growth tendency. In the literature, however, cases of hemangioma growth during pregnancy or after estrogen administration are described.[1][2]
  • Several studies have concluded that a spontaneous rupture of a hemangioma (even while pregnancy) occurs only very rarely.[2]
Complications

Complications

Complications of hepatic hemangioma include:[1][2]

  • Spontaneous rupture
Prognosis

Prognosis

  • The case fatality rate of patients with spontaneous rupture of hepatic hemangioma is approximately 30-40% despite therapy.[2]
References

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 Assy, Nimer (2009). “Characteristics of common solid liver lesions and recommendations for diagnostic workup”. World Journal of Gastroenterology. 15 (26): 3217. doi:10.3748/wjg.15.3217. ISSN 1007-9327.
  2. ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 Ehrl, Denis; Rothaug, Katharina; Herzog, Peter; Hofer, Bernhard; Rau, Horst-Günter (2012). ““Incidentaloma” of the Liver: Management of a Diagnostic and Therapeutic Dilemma”. HPB Surgery. 2012: 1–14. doi:10.1155/2012/891787. ISSN 0894-8569.
  3. ↑ “Adult hepatic hemangioma: an updated review with focus on the natural course and treatment options”. Abdomen. 2015. doi:10.14800/abdomen.908. ISSN 2378-1351.
  4. ↑ Maruyama, Masaki; Isokawa, Osamu; Hoshiyama, Koki; Hoshiyama, Ayako; Hoshiyama, Mari; Hoshiyama, Yoshihiro (2013). “Diagnosis and Management of Giant Hepatic Hemangioma: The Usefulness of Contrast-Enhanced Ultrasonography”. International Journal of Hepatology. 2013: 1–6. doi:10.1155/2013/802180. ISSN 2090-3448.
  5. ↑ Donati, Marcello; Stavrou, Gregor A.; Donati, Angelo; Oldhafer, Karl J. (2011). “The risk of spontaneous rupture of liver hemangiomas: a critical review of the literature”. Journal of Hepato-Biliary-Pancreatic Sciences. 18 (6): 797–805. doi:10.1007/s00534-011-0420-7. ISSN 1868-6974.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Nawal Muazam M.D.[2]