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.
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.
A biopsy is contraindicated in hepatic hemangioma due to its vasculature nature that risks bleeding, especially in large and subcapsular masses.
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 is indicated in hepatic hemangioma patients with rapid growth, unresponsive to analgesic, risk of intratumoral thrombosis, and rupture.
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