Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2009, vol. 18, nr 1, January-February, p. 7–12

Publication type: editorial article

Language: English

Surgical Resection of Giant Liver Hemangiomas – Literature Review and Report of a Special Case

Jakob Burcharth1,, Paweł Domosławski1,, Flemming Burcharth1,

1 Department of Surgical Gastroenterology, Herlev Hospital, University of Copenhagen, Denmark

Abstract

Hepatic hemangiomas are the most common hepatic lesion. They have a female predominance in all age groups, are often asymptomatic, and are increasingly found incidentally on abdominal ultrasound (US) or computer tomographic (CT) examinations. Hepatic hemangiomas can be single or multiple and are vascular malformations that grow by ectasia rather than neoplasia. Large hemangiomas can produce a variety of symptoms from discomfort to life−threatening complications. The complications are rare but include compression of adjacent organs, rupture, and Kasabach−Merritt syndrome. Magnetic resonance imaging (MRI) is the best imaging method to establish the diagnosis. Treatment modalities for giant hepatic hemangiomas, such as arterial ligation, radiotherapy, and corticosteroid and interferon therapy, have been implemented without any convincing success. Surgical resection is so far the only consistently curative method of treatment. Indications for performing surgery of hepatic hemangiomas should be severe unacceptable symptoms, growth of the tumor, inability to exclude malignancy, persons with a high risk of hepatic injury, and complications. If surgery is indicated, different techniques can be used, including enucleation, hepatic resection, and laparoscopic techniques. When the diagnosis of hepatic lesions is uncertain despite thorough radiological evaluation and biochemical analysis, percutaneous biopsy is recommended, and the latest open laparotomy with biopsy and/or resection. The authors believe that considered hepatic resection of benign lesions in the liver in appropriately chosen patients is a safe procedure. A report of a special case of a giant liver hemangioma and a literature review on the diagnosis and treatment of hemangiomas of the liver are presented.

Key words

hepatic hemangioma, giant, surgical treatment, complications

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