Liver Hemangiomas: Risks, Treatment, and Surgery Options

Hemangioma

My aunt recently underwent ultrasound and CT scans, which revealed three hemangiomas in her liver, one of which is 5 centimeters in size and located between two major arteries.
I would like to know if there is a possibility that the hemangiomas could grow larger.
The doctor mentioned that the hemangioma located near the major arteries is more complicated; what does that mean? Does she need surgery? Can hemangiomas turn into liver cancer? What is the best way to manage this situation? Thank you!

Miss Lin, 30~39 year old female. Ask Date: 2005/06/03

Dr. Xu Jinchuan reply Gastroenterology and Hepatology

Hello! Generally speaking, hemangiomas do not enlarge rapidly in a short period of time; any growth typically occurs over several years and may only be slight.
Since various examinations have confirmed the presence of a hemangioma, surgical removal is generally not recommended, especially since it is located near major blood vessels.
Overall, the situation does not require immediate intervention.
The formation of hemangiomas is related to individual body constitution, and the exact cause is not well understood.
Hemangiomas do not affect liver function and are unlikely to evolve into liver cancer, so regular monitoring is sufficient.

Reply Date: 2005/06/03

More Info

Liver hemangiomas are benign tumors formed by a mass of blood vessels in the liver. They are the most common type of benign liver tumors and are often discovered incidentally during imaging studies, such as ultrasounds or CT scans. In your case, your aunt has three hemangiomas, one of which is 5 cm and located between two major arteries.

Risks and Growth Potential
The growth potential of liver hemangiomas is generally low. Most hemangiomas remain stable in size and do not cause symptoms. However, in some cases, they can grow larger, particularly if they are larger than 4 cm. The risk of complications, such as rupture or bleeding, increases with size, especially if they are located near major blood vessels, as in your aunt's case.

Surgical Considerations
When a hemangioma is located near major arteries, it can complicate surgical intervention. The proximity to large blood vessels may increase the risk of bleeding during surgery, making it a more delicate procedure. If the hemangioma is asymptomatic and stable, doctors often recommend a conservative approach, which includes regular monitoring through imaging studies rather than immediate surgery.
However, if the hemangioma is symptomatic (causing pain, discomfort, or other complications) or if there is a concern about its growth or potential rupture, surgical options may be considered. Surgery can involve either resection of the hemangioma or, in some cases, embolization, which is a procedure that blocks the blood supply to the tumor, causing it to shrink.

Risk of Malignancy
It is important to note that liver hemangiomas do not turn into liver cancer. They are benign lesions and are not associated with an increased risk of hepatocellular carcinoma (the most common type of liver cancer). However, other liver conditions, such as cirrhosis or chronic hepatitis, can increase the risk of liver cancer, so it is essential to monitor overall liver health.

Management and Monitoring
For your aunt, the best course of action will depend on her symptoms, the size of the hemangiomas, and their location. Regular follow-up with imaging studies (usually every 6 to 12 months) is recommended to monitor the hemangiomas for any changes in size or symptoms. If she experiences any new symptoms, such as abdominal pain, nausea, or changes in appetite, she should consult her healthcare provider immediately.

In summary, while the presence of liver hemangiomas can be concerning, especially with one being 5 cm and located near major arteries, they are typically benign and manageable. Surgical intervention is usually reserved for symptomatic cases or those with significant growth. Regular monitoring and a thorough discussion with her healthcare provider will help determine the best approach for her specific situation.

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