Hepatic hemangiomas are thought to be present in as many as 7% of healthy people. Hemangiomas are four to six times more common in women than in men. Female hormones may promote the formation and growth of hemangiomas.
Hemangiomas, although referred to as tumors, are not malignant and do not become cancerous. Hemangiomas are not unique to the liver and can occur almost anywhere in the body.
What are the symptoms of a hepatic hemangioma?
Hemangiomas usually are small, measuring only a quarter inch in diameter, but they can be several inches in diameter or even larger.
The vast majority of hemangiomas of the liver never cause symptoms or health problems. Most hepatic hemangiomas are discovered incidentally at the time of testing for unrelated medical problems, most commonly with ultrasound imaging or CT (computerized tomography) scanning of the abdomen.
Very large hemangiomas can cause symptoms, especially if they are positioned near other organs. Pain, nausea, or enlargement of the liver can occur. Rarely, larger hemangiomas can rupture, causing severe pain and bleeding into the abdomen that may be severe or even life threatening.
Causes and Risk Factors for Liver Hemangiomas
Experts are unsure why blood vessels group together and form a liver hemangioma. However, they do agree that liver hemangiomas are most likely congenital, meaning they are passed down through families.
Most liver hemangiomas are diagnosed in patients between the ages of 30 and 50.
Women are more likely than men to develop liver hemangiomas. Women who are on hormone therapy to increase their estrogen levels are at an increased risk of developing liver hemangiomas.
How is the diagnosis of a hepatic hemangioma made?
When a hemangioma is suspected, the challenge for the health care professional, is to be sure that it is in fact a hemangioma and not another type of tumor, particularly a malignant one.
With specialized tests, however, doctors can reassure patients that the tumor is with little doubt a hemangioma.
Such special testing may include scintigraphy (using a tiny amount of a radioactive substance to identify the hemangioma), CT scanning, or MRI (magnetic resonance imaging).
In general, a biopsy of suspected hemangiomas is avoided because of their benign nature and the potential risk of bleeding from the biopsy.
How Is a Liver Hemangioma Diagnosed?
In those who do not display symptoms, liver hemangiomas are often overlooked until accidentally found during testing for other problems.
Liver hemangiomas are usually found using an imaging test—such as an ultrasound, CT scan, MRI scan, or a single photon emission computerized tomography (SPECT) scan.
These imaging tests allow your doctor to see intricate details of your liver and its surrounding structures. If your doctor is looking for other liver issues, he or she may find a hemangioma.
What Are the Treatment Options for a Liver Hemangioma?
Most liver hemangiomas do not require treatment. However, if the hemangioma is large or causes symptoms, it can be removed surgically. If the hemangioma causes significant pain or damage to an area of the liver, then your doctor may decide to remove the entire damaged section.
A hemangioma can grow if there is a significant amount of blood flowing to it. In this case, the doctor may tie off the main artery supplying hemangioma with blood.
The surrounding areas of the liver will still receive blood from other arteries and remain healthy. This surgical procedure is called hepatic artery ligation.
Alternatively, a medication can be injected into the liver hemangioma to block the blood supply. This is called arterial embolization.
In extremely rare cases, a liver transplant surgery may be necessary. This only occurs in cases of extremely large liver hemangiomas, or multiple liver hemangiomas that do not respond to other treatments.
In extremely rare cases, radiation treatments may be required to shrink the mass.
The vast majority of hepatic hemangiomas require no treatment. If a hepatic hemangioma is large, especially if it is causing symptoms, surgical removal is an option.
Part 6 of 7: Complications
Will a Liver Hemangioma Cause Complications?
Liver hemangiomas rarely cause any complications. Complications that can arise in rare cases are:
If you are pregnant, using hormone therapy, or have liver disease, talk to your doctor in order to reduce your risk of developing these complications.
Most cases of liver hemangiomas cause no health risks in the future. In very rare cases, a liver transplant may be necessary.
People who have a liver transplant may need to take medication for the rest of their lives to keep their body from rejecting the transplanted liver. Your doctor will monitor the hemangioma to prevent these risks.