Do You Need Further Diagnosis for Growing Liver Hemangiomas?

If a hepatic hemangioma is found to be enlarging, is further diagnosis necessary?

Hello, Doctor.
Six years ago, I was diagnosed with a hepatic hemangioma measuring approximately 2 cm during an ultrasound examination.
All other values were normal, and I do not have hepatitis.
I have been monitored for four years, and the hemangioma remained about the same size.
However, during an ultrasound last year, the hemangioma increased to 2.6 cm.
A subsequent CT scan reported it as a benign hemangioma measuring 2.8 cm.
During a follow-up ultrasound earlier this year, the hemangioma was measured at 3.4 cm.
I have been monitored annually.
If the hemangioma increases in size again during next year's examination, will further testing be necessary? Is there a possibility that it could transform into a malignant tumor? Thank you.

Xiao P, 30~39 year old female. Ask Date: 2016/02/16

Dr. Chen Qifeng reply Gastroenterology and Hepatology

In general, the likelihood of hepatic hemangiomas enlarging is very rare.
If a series of follow-ups shows that they are indeed growing, surgical intervention may be considered.
Wishing you good health.

Reply Date: 2016/02/16

More Info

When it comes to liver hemangiomas, particularly in your case where there has been a gradual increase in size over the years, it is essential to approach the situation with careful consideration. Liver hemangiomas are the most common benign tumors of the liver, and they are typically asymptomatic. Most patients with liver hemangiomas do not require treatment unless there are complications or significant growth that raises concerns.

In your situation, the hemangioma has shown a steady increase in size from 2 cm to 3.4 cm over the course of several years. While this growth is notable, it is important to understand that the majority of liver hemangiomas remain benign and do not transform into malignant tumors. The risk of a hemangioma becoming cancerous is extremely low, but monitoring is crucial to ensure that any changes in size or characteristics are appropriately evaluated.

Given that you have been undergoing regular follow-ups with ultrasound and CT scans, you are already on the right track. The current guidelines suggest that if a hemangioma is stable in size (typically defined as no significant change over a period of 6 to 12 months), then continued monitoring with ultrasound is usually sufficient. However, if there is a significant increase in size or if the hemangioma begins to exhibit atypical features (such as irregular borders or internal calcifications), further imaging studies, such as MRI, may be warranted for a more detailed assessment.

MRI is particularly useful in differentiating hemangiomas from other liver lesions due to its superior soft tissue contrast and ability to visualize vascular structures. It can provide a clearer picture of the hemangioma's characteristics and help rule out other potential issues, such as liver cancer or other types of tumors.

If you find that your hemangioma continues to grow, it would be prudent to discuss with your healthcare provider the possibility of additional imaging studies, such as an MRI, to assess the lesion more thoroughly. In some cases, if the hemangioma grows significantly (usually over 4-5 cm) or causes symptoms (such as pain or discomfort), surgical intervention may be considered. However, this is generally reserved for rare cases where the hemangioma is symptomatic or there is uncertainty regarding the diagnosis.

In summary, while your hemangioma has shown growth, the likelihood of it becoming malignant is low. Regular monitoring is essential, and if there are any significant changes in size or characteristics, further imaging may be necessary. Always maintain open communication with your healthcare provider, who can guide you based on the most current clinical guidelines and your specific situation. Regular follow-ups and imaging will help ensure that any potential issues are caught early, allowing for timely intervention if needed.

Similar Q&A

Understanding Liver Hemangiomas: Diagnosis, Monitoring, and Treatment Options

If a tumor has been found on the liver and initial tests suggest it is a benign tumor (hemangioma), should I undergo further testing to confirm that it is indeed a hemangioma, or should I follow the doctor's recommendation to return for follow-up every three months? If the h...

Dr. Chen Shidian reply Gastroenterology and Hepatology
Dear Ms. May, Hepatic hemangiomas are quite common, and physicians should have the experience to diagnose them. As long as you continue with regular follow-ups, if there are any changes, the physician will advise whether surgery is necessary. Changhua Hospital cares about your ...

Understanding Liver Hemangiomas: Should You Seek a Second Opinion?

Hello Doctor: In February, I visited the emergency room due to discomfort and unexpectedly discovered a 4 cm hepatic hemangioma. Since I was unfamiliar with this condition and did not know any doctors, I randomly consulted a hepatobiliary specialist at a large hospital. My liver ...

Dr. Chen Shidian reply Gastroenterology and Hepatology
Hello Isa, please rest assured. The CT scan is quite accurate, but it is essential to follow up on time. If you are still concerned, a fine needle aspiration biopsy can be performed for pathological examination. However, this is generally not necessary. Changhua Hospital cares ab...

Understanding Liver Hemangiomas: When to Seek Further Imaging

Hello, Dr. Lin. I would like to ask the following question. I was diagnosed as a carrier of hepatitis B over a decade ago. Therefore, I have been getting checked every six months to a year. Currently, my AST and ALT levels, as well as alpha-fetoprotein, are all normal, but an ult...

Dr. Lin Minghui reply Gastroenterology and Hepatology
Hello, this issue should be discussed with your physician. Tumors can present in very typical ways, resembling hepatocellular carcinoma or hemangiomas. If the distinction is not clear and there is a possibility of liver cancer, further imaging studies are necessary. In cases of s...

Understanding the Growth of Liver Hemangiomas: What You Need to Know

Hello, Doctor: Our company conducts health check-ups every year. During the first year, an ultrasound examination revealed that I have a 5 cm hepatic hemangioma. The doctor referred me to the hospital for an MRI, which confirmed the diagnosis of a hemangioma. The doctor mentioned...

Dr. Lin Minghui reply Gastroenterology and Hepatology
Hemangiomas are benign tumors caused by vascular proliferation, with unknown origins. Some are congenital, while others may be related to hormones. Generally, hemangiomas are asymptomatic; however, if they are large (greater than 10 centimeters), they may present symptoms such as...