Hepatic hemangioma natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Nawal Muazam M.D.[2]
Overview
If left untreated, patients with giant hepatic hemangiomas may progress to develop complications. Complications of hepatic hemangioma include spontaneous rupture, acute hemorrhagic shock, and upper abdominal pain.[1][2] Prognosis is generally excellent, and the mortality rate of patients with spontaneous rupture of hepatic hemangioma is approximately 30-40%.[2]
Natural history
- Most of the hepatic hemangiomas are characterized by benign uncomplicated course and most lesions are asymptomatic.[3]
- Hepatic hemangioma is the most common benign liver tumor and typically remains stable in size.[4]
- These are usually diagnosed as asymptomatic incidental findings.
- Hemangiomas also (rarely) rupture spontaneously or by trauma and then lead to acute hemorrhagic shock with upper abdominal pain.[1][2]
- In the worldwide literature a total of only 97 cases with a rupture of a hemangioma have been published, whereas a spontaneous rupture only happened in 47.4% of cases.[5][2]
- Hemangiomas generally have no growth tendency. In the literature, however, cases of hemangioma growth during pregnancy or after estrogen administration are described.[1][2]
- Several studies have concluded that a spontaneous rupture of a hemangioma (even while pregnancy) occurs only very rarely.[2]
Complications
Complications of hepatic hemangioma include:[1][2]
- Spontaneous rupture
Prognosis
- The case fatality rate of patients with spontaneous rupture of hepatic hemangioma is approximately 30-40% despite therapy.[2]
References
- ↑ 1.0 1.1 1.2 1.3 1.4 Assy, Nimer (2009). "Characteristics of common solid liver lesions and recommendations for diagnostic workup". World Journal of Gastroenterology. 15 (26): 3217. doi:10.3748/wjg.15.3217. ISSN 1007-9327.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 Ehrl, Denis; Rothaug, Katharina; Herzog, Peter; Hofer, Bernhard; Rau, Horst-Günter (2012). ""Incidentaloma" of the Liver: Management of a Diagnostic and Therapeutic Dilemma". HPB Surgery. 2012: 1–14. doi:10.1155/2012/891787. ISSN 0894-8569.
- ↑ "Adult hepatic hemangioma: an updated review with focus on the natural course and treatment options". Abdomen. 2015. doi:10.14800/abdomen.908. ISSN 2378-1351.
- ↑ Maruyama, Masaki; Isokawa, Osamu; Hoshiyama, Koki; Hoshiyama, Ayako; Hoshiyama, Mari; Hoshiyama, Yoshihiro (2013). "Diagnosis and Management of Giant Hepatic Hemangioma: The Usefulness of Contrast-Enhanced Ultrasonography". International Journal of Hepatology. 2013: 1–6. doi:10.1155/2013/802180. ISSN 2090-3448.
- ↑ Donati, Marcello; Stavrou, Gregor A.; Donati, Angelo; Oldhafer, Karl J. (2011). "The risk of spontaneous rupture of liver hemangiomas: a critical review of the literature". Journal of Hepato-Biliary-Pancreatic Sciences. 18 (6): 797–805. doi:10.1007/s00534-011-0420-7. ISSN 1868-6974.