Cavernous liver haemangioma
|Cavernous liver haemangioma|
|Hemangioma of the liver as seen on ultrasound|
|Classification and external resources|
A cavernous liver haemangioma or hepatic haemangioma is a benign tumour of the liver composed of hepatic endothelial cells. It is the most common liver tumour, and is usually asymptomatic and diagnosed incidentally on radiological imaging. Liver haemangiomas are thought to be congenital in origin. Several subtypes exist, including the giant hepatic haemangioma, which can cause significant complications.
Liver haemangiomas are typically hyperechoic on ultrasound though may occasionally be hypoechoic; ultrasound is not diagnostic. Computed tomography (CT), magnetic resonance imaging (MRI) or single-photon emission computed tomography (SPECT) using autologous labelled Red Blood Cells (RBC) with Tc-99m is diagnostic. Biopsy is avoided due to the risk of haemorrhage.
- Typical hepatic haemangioma
- Atypical hepatic haemangioma
- Giant hepatic haemangioma
- Flash filling hepatic haemangioma – can account for up to 16% of all hepatic haemangiomas
- Calcified hepatic haemangioma
- Hyalinized hepatic haemangioma
- Other unusual imaging patterns
- Hepatic heamangioma with capsular retraction
- Hepatic haemangioma with surrounding regional nodular hyperplasia
- Hepatic haemangioma with fatty infiltration
- Pedunculated hepatic haemangioma
- Cystic hepatic haemangioma – rare
- Fluid-fluid level containing hepatic haemangioma – rare
Giant hepatic haemangioma
This large, atypical haemangioma of the liver may present with abdominal pain or fullness due to haemorrhage, thrombosis or mass effect. It may also lead to left ventricular volume overload and heart failure due to the increase in cardiac output which it causes. Further complications are Kasabach-Merritt syndrome, a form of consumptive coagulopathy due to thrombocytopaenia, and rupture.
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