Atypical giant hepatic hemangioma. A case report

Abstract

Giant hepatic hemangiomas are lesions included in the atypical hemangiomas category. In most cases they have a benign behavior, predominantly present in women with ages ranging from 20 to 60, and are commonly located in the right liver lobe with a size larger than 4 cm. The  diagnosis is usually made incidentally because they generally don´t produce any symptoms; however, when they are large they tend to manifest persistent abdominal symptoms. In images, among the most common findings in ultrasonography are: hyperechoic lesions with peripheral feeding vessels and posterior acoustic reinforcement; on CT the most frequent findings are heterogeneous lesions with a markedly hypoattenuating central area that has nodular peripheral enhancement in the arterial phase after intravenous contrast administration; some atypical findings include hemorrhage, thrombus, calcifications, capsules or pseudocapsules. Although most of these lesions only require observation, some patients require treatment, either surgical (enucleation, resection) or interventional radiology procedures such as angiographic selective embolization.