There are two types of liver hemangioma: cavernous and hemangioendothelioma.
Hemangioendotheliomata are generally seen only in children.
Cavernous hemangiomas occur in individuals of all ages and throughout the world. They are more commonly found in older persons and rarely identified in young children. Cavernous hemangiomas are more common in women than men. Estrogens may increase their size.
Cavernous hemangioma can vary in size and be as large as several centimeters. The margins of the tumors
are usually well defined. Hemangiomas are filled with vascular channels of various sizes and also contain
fibrous tissue. Thrombi (clotted blood) may be present in the vascular channels.
Cavernous hemagioma are usually asymptomatic and diagnosed incidentally when ultrasound, CT or other
abdominal imaging studies are undertaken for other reasons. Sometime, a patient with a hemangioma will
present with abdominal pain, nausea, vomiting, other abdominal symptoms or a palpable mass. Rarely,
patients with hemangioma will present with anemia or low platelet counts because red blood cells or
platelets are sequestered and/or destroyed in the tumor. Very rarely, a hemangioma can rupture, usually
after abdominal trauma.
Diagnosis of cavernous hemangioma is made by special imaging studies. Routine ultrasound is suggestive
but usually not diagnostic. Diagnosis can usually be made by nuclear medicine scans using radioactive
technetium tagged red blood cells, magnetic resonance or dynamic CT scan with contrast. Rarely, hepatic
angiogram is necessary to make a definite diagnosis of hemangioma.
Cavernous hemangiomas are benign. There is no risk of developing into cancer. If the patient is asymptomatic, no treatment is necessary. Large, symptomatic hemangiomas are treated by surgical resection.