Giant hemangioma of the liver.

Abstract

Six patients with hemangioma of the liver larger than 5 cm in diameter were treated at the Montreal General Hospital between 1968 and 1981. Two patients were symptomatic, complaining of nonspecific right upper quadrant pain. One man presented in a dramatic fashion when he bled from a ruptured hemangioma after a fall. Arteriography in three of the patients revealed characteristic filling of the vascular spaces commencing in the arterial phase with persistent dense accumulation in the venous phase. A timed, infusion computerized axial tomogram in one case revealed prolonged opacification, occurring from the periphery of the lesion towards the centre over several minutes. All six hemangiomas were benign; they consisted of large blood spaces separated by fine fibrous septae. They appeared to expand by incorporating marginal liver sinusoids. Organizing thrombus was often seen; this could account for the right upper quadrant pain. The patients were treated by partial or total hepatic lobectomy to relieve symptoms and prevent hemorrhage due to trauma. On two occasions, nodules of hemangioma were left behind but none of the six patients showed evidence of recurrence on follow-up.