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Medicine (MD/DO)
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First Aid
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First Aid for the USMLE Step 1 (2023)
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Hepatic Hemangioma

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Hepatic Hemangioma

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Hepatic Hemangioma

Liver He-man-gnome
DikeHAfifi
9 KEY FACTS
CHARACTERISTICS
Benign Venous Malformation
Bunny Vines Malformed

The etiology of hepatic hemangioma is still not well understood. Still, it is thought to be related to venous malformations or hamartomas of congenital origin that extend by ectasia rather than by hyperplasia or hypertrophy.

Most Common Benign Liver Tumor
#1 Foam-finger Liver Tumor-guy

Hepatic hemangioma is the most common benign liver tumor.

Appears in Patients 30-50 Years Old
(30) Dirty and (50) Cent

Patients are usually diagnosed with hepatic hemangioma at the age of 30-50 years old.

CLINICAL FEATURES
Asymptomatic
Thumbs-up

Hepatic hemangioma is commonly found incidentally during imaging, and patients often seem asymptomatic.

Abdominal Pain
Abdominal Pain-bolt

Even though it is often asymptomatic, a hepatic hemangioma can be experienced with upper abdominal pain if the mass is large enough to distend Glisson's capsule. Patients can present with a sensation of fullness.

DIAGNOSIS
MRI
M-R-eyes Machine

MRI is used to diagnose hepatic hemangiomas with a 90% sensitivity and 91%-99% specificity. Other modalities that may be helpful to diagnose are CT and ultrasound.

CONSIDERATIONS
Biopsy Contraindicated
Biopsy-needle Caution-tape

A biopsy is contraindicated in hepatic hemangioma due to its vasculature nature that risks bleeding, especially in large and subcapsular masses.

TREATMENT
Observation
Observatory

In current studies, no pharmacotherapy is found able to reduce the mass size of hepatic hemangioma. No treatment is necessary for asymptomatic patients. However, observation needs to be considered in a patient.

Surgery
Surgeon-with-scalpel

Surgery is indicated in hepatic hemangioma patients with rapid growth, unresponsive to analgesic, risk of intratumoral thrombosis, and rupture.

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