Master Hepatic Hemangioma with Picmonic for Medicine

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.

Hepatic hemangioma is the most common benign liver tumor.

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

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

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.

Ultrasound is typically the first imaging tool used when a focal liver lesion is suspected. If typical features are present and there is no history of liver diseases, such as cirrhosis or malignancy, it can diagnose hepatic hemangioma.

CT scan or MRI is used to diagnose hepatic hemangiomas with a 90% sensitivity and 91%-99% specificity. Mostly, they are used when ultrasound criteria for hepatic hemangioma are not met.

A biopsy is contraindicated in hepatic hemangioma due to its heavy vasculature, which increases the risk of bleeding, especially in large and subcapsular masses.

In current studies, no pharmacotherapy is found to be 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 is indicated in hepatic hemangioma patients with rapid growth, unresponsive to analgesic, risk of intratumoral thrombosis, and rupture.