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Hepatic hemangioma

Liver hemangioma; Hemangioma of the liver; Cavernous hepatic hemangioma; Infantile hemangioendothelioma; Multinodular hepatic hemangiomatosis

A hepatic hemangioma is a liver mass made of widened (dilated) blood vessels. It is not cancerous.

Causes

A hepatic hemangioma is the most common type of liver mass that is not caused by cancer. It may be a birth defect.

Hepatic hemangiomas can occur at any time. They are most common in people in their 30s to 50s. Women get these masses more often than men. The masses are often bigger in size.

Babies may develop a type of hepatic hemangioma called benign infantile hemangioendothelioma. This is also known as multinodular hepatic hemangiomatosis. This is a rare, noncancerous tumor that has been linked to high rates of heart failure and death in infants. Infants are most often diagnosed by the time they are 6 months old.

Symptoms

Some hemangiomas may cause bleeding or interfere with organ function. Most do not produce symptoms. In rare cases, the hemangioma may rupture.

Exams and Tests

In most cases, the condition is not found until liver images are taken for some other reason. If the hemangioma ruptures, the only sign may be an enlarged liver.

Babies with benign infantile hemangioendothelioma may have:

  • A growth in the abdomen
  • Anemia
  • Signs of heart failure

The following tests may be performed:

Treatment

Most of these tumors are treated only if there is ongoing pain.

Treatment for infantile hemangioendothelioma depends on the child's growth and development. The following treatments may be needed:

  • Inserting a material in a blood vessel of the liver to block it (embolization)
  • Tying off (ligation) a liver artery
  • Medicines for heart failure
  • Surgery to remove the tumor

Outlook (Prognosis)

Surgery can cure a tumor in an infant if it is only in one lobe of the liver. This can be done even if the child has heart failure.

Possible Complications

Pregnancy and estrogen-based medicines can cause these tumors to grow.

The tumor may rupture in rare cases.

References

Di Bisceglie AM, Befeler AS. Hepatic tumors and cysts. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 96.

Mendes BC, Tollefson MM, Bower TC. Pediatric vascular tumors. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019:chap 188.

Soares KC, Pawlik TM. The management of liver hemangioma. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 12th ed. Philadelphia, PA: Elsevier; 2017:349-354.

  • Hemangioma - angiogram

    Hemangioma - angiogram - illustration

    This angiogram (an X-ray taken after dye has been injected into the blood stream) shows a mass of blood vessels (hemangioma) in the liver.

    Hemangioma - angiogram

    illustration

  • Hemangioma - CT scan

    Hemangioma - CT scan - illustration

    This upper abdominal CT scan shows a blood vessel tumor (hemangioma) in the liver.

    Hemangioma - CT scan

    illustration

  • Digestive system organs

    Digestive system organs - illustration

    The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.

    Digestive system organs

    illustration

    • Hemangioma - angiogram

      Hemangioma - angiogram - illustration

      This angiogram (an X-ray taken after dye has been injected into the blood stream) shows a mass of blood vessels (hemangioma) in the liver.

      Hemangioma - angiogram

      illustration

    • Hemangioma - CT scan

      Hemangioma - CT scan - illustration

      This upper abdominal CT scan shows a blood vessel tumor (hemangioma) in the liver.

      Hemangioma - CT scan

      illustration

    • Digestive system organs

      Digestive system organs - illustration

      The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.

      Digestive system organs

      illustration

     

    Review Date: 3/25/2019

    Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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