Liver Hemangiomas: Causes, Risks, and Management Tips

Hepatic hemangioma

My mother (60 years old) underwent a CT scan of the liver, which revealed two hepatic hemangiomas measuring 4.4 cm and 4.2 cm.
I would like to ask the doctor: 1.
What are the causes of hepatic hemangiomas? 2.
Will they continue to grow? Is there a risk of rupture? Could this be life-threatening? 3.
Are there any medications available to control their growth? What precautions should be taken in daily life?

George, 60~69 year old female. Ask Date: 2008/10/06

Dr. Lin Minghui reply Gastroenterology and Hepatology

1.
Hepatic hemangiomas are tumors formed by abnormal proliferation of blood vessels within the liver, with unknown etiology.
Some are congenital, while others may be related to female hormones.

2.
Hepatic hemangiomas grow very slowly, and may not increase in size at all.
Generally, they are asymptomatic, but large hemangiomas can sometimes cause pressure and pain, and may lead to complications such as vascular embolism, infarction, or rupture with bleeding.
In emergencies, surgical intervention or embolization may be necessary.

3.
Hepatic hemangiomas typically do not require treatment, and there are no oral medications available to make them disappear or control their growth.
Hemangiomas are not harmful, and if confirmed as hepatic hemangiomas, regular follow-up (every 4-6 months) is sufficient, along with being cautious to avoid trauma in daily life.

Best regards,
Dr.
Lin Ming-Hui, Taoyuan Hospital, Department of Health.

Reply Date: 2008/10/06

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 CT scans or ultrasounds, as they usually do not cause symptoms. In your mother's case, the discovery of two hemangiomas measuring 4.4 cm and 4.2 cm raises several important questions regarding their nature, potential risks, and management.

1. Causes of Liver Hemangiomas: The exact cause of liver hemangiomas remains unclear. They are believed to be congenital, meaning they may be present at birth, although they often do not become apparent until later in life. Some studies suggest that hormonal factors, particularly estrogen, may play a role in their development, which could explain why they are more common in women. Other risk factors may include certain liver diseases, but in many cases, there are no identifiable risk factors.

2. Growth and Risks: Hemangiomas typically grow very slowly, and many remain stable in size over time. In most cases, they do not cause any symptoms and are not life-threatening. However, larger hemangiomas (generally over 4 cm) can sometimes lead to complications such as abdominal pain, nausea, or a feeling of fullness due to pressure on surrounding organs. In rare cases, they can rupture, leading to internal bleeding, which can be a medical emergency. However, the likelihood of this occurring is quite low. Regular monitoring through imaging studies is often recommended to ensure that the hemangiomas do not grow significantly or cause complications.

3. Treatment Options: Generally, liver hemangiomas do not require treatment unless they cause symptoms or complications. There are no specific medications available to shrink or control the growth of hemangiomas. Instead, the standard approach is to monitor them with periodic imaging (every 6 to 12 months) to assess for any changes in size or symptoms. If a hemangioma becomes symptomatic or grows significantly, treatment options may include surgical resection or, in some cases, embolization (a procedure to block the blood supply to the hemangioma).

Lifestyle Considerations: While there are no specific lifestyle changes required for individuals with liver hemangiomas, maintaining overall liver health is essential. This includes:
- Avoiding Alcohol: Excessive alcohol consumption can lead to liver damage and should be avoided.

- Healthy Diet: A balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support liver health.

- Regular Exercise: Engaging in regular physical activity can help maintain a healthy weight and reduce the risk of liver disease.

- Routine Check-ups: Regular follow-ups with a healthcare provider for monitoring liver health and any changes in the hemangiomas are crucial.

In conclusion, while the discovery of liver hemangiomas can be concerning, they are typically benign and manageable with regular monitoring. It is essential to maintain a healthy lifestyle and stay vigilant with follow-up appointments to ensure that any changes are promptly addressed. If your mother experiences any new symptoms, such as abdominal pain or changes in appetite, it is important to consult her healthcare provider for further evaluation.

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