eMedicine Specialties > Radiology > Gastrointestinal

Cavernous Hemangioma, Liver: Multimedia

Author: Srinivasa R Prasad, MD,, Professor, Department of Radiology and Section Chief, Division of Abdominal Imaging, University of Texas Health Science Center at San Antonio
Coauthor(s): Dushyant Sahani, MD, Clinical Instructor of Abdominal Radiology and Intervention, Harvard Medical School; Assistant Radiologist, Department of Abdominal Imaging and Intervention, Massachusetts General Hospital; Sanjay Saini, MD, Associate Professor, Department of Radiology, Harvard Medical School; Vice Chairman, Department of Radiology, Health System Affairs, Massachusetts General Hospital
Contributor Information and Disclosures

Updated: Aug 12, 2009

Multimedia

Contrast-enhanced computed tomography (CT) scan t...Media file 1: Contrast-enhanced computed tomography (CT) scan that was obtained during the arterial-dominant phase. This image demonstrates a hemangioma with homogeneous and intense contrast enhancement.
Contrast-enhanced computed tomography (CT) scan t...

Contrast-enhanced computed tomography (CT) scan that was obtained during the arterial-dominant phase. This image demonstrates a hemangioma with homogeneous and intense contrast enhancement.

Contrast-enhanced computed tomography (CT) scan. ...Media file 2: Contrast-enhanced computed tomography (CT) scan. These images reveal the pathognomonic features of a hemangioma, namely, peripheral nodular enhancement and progressive centripetal fill-in (arrow). The smaller, peripheral lesion (circled) shows homogeneous enhancement.
Contrast-enhanced computed tomography (CT) scan. ...

Contrast-enhanced computed tomography (CT) scan. These images reveal the pathognomonic features of a hemangioma, namely, peripheral nodular enhancement and progressive centripetal fill-in (arrow). The smaller, peripheral lesion (circled) shows homogeneous enhancement.

Magnetic resonance image (MRI) of a hemangioma. T...Media file 3: Magnetic resonance image (MRI) of a hemangioma. The lesion appears as a hypointense mass on T1-weighted MRIs (T1WI) and as a hyperintense mass on dual-echo T2-weighted MRIs (T2WI). Note that the signal intensity of the lesion is similar to that of the adjacent cerebrospinal fluid.
Magnetic resonance image (MRI) of a hemangioma. T...

Magnetic resonance image (MRI) of a hemangioma. The lesion appears as a hypointense mass on T1-weighted MRIs (T1WI) and as a hyperintense mass on dual-echo T2-weighted MRIs (T2WI). Note that the signal intensity of the lesion is similar to that of the adjacent cerebrospinal fluid.

Dynamic gadolinium (Gd)-enhanced magnetic resonan...Media file 4: Dynamic gadolinium (Gd)-enhanced magnetic resonance images (MRIs). These images demonstrate the progressive, centripetal contrast enhancement in a hemangioma.
Dynamic gadolinium (Gd)-enhanced magnetic resonan...

Dynamic gadolinium (Gd)-enhanced magnetic resonance images (MRIs). These images demonstrate the progressive, centripetal contrast enhancement in a hemangioma.

Gray-scale and Doppler ultrasonographic (US) imag...Media file 5: Gray-scale and Doppler ultrasonographic (US) images. These sonograms show a well-defined, uniformly hyperechoic liver mass with peripheral feeder vessels that are characteristic of a hemangioma.
Gray-scale and Doppler ultrasonographic (US) imag...

Gray-scale and Doppler ultrasonographic (US) images. These sonograms show a well-defined, uniformly hyperechoic liver mass with peripheral feeder vessels that are characteristic of a hemangioma.

More on Cavernous Hemangioma, Liver

Overview: Cavernous Hemangioma, Liver
Imaging: Cavernous Hemangioma, Liver
Follow-up: Cavernous Hemangioma, Liver
Multimedia: Cavernous Hemangioma, Liver
References
Further Reading

References

  1. Karhunen PJ. Benign hepatic tumours and tumour like conditions in men. J Clin Pathol. Feb 1986;39(2):183-8. [Medline][Full Text].

  2. Dodd GD 3rd, Baron RL, Oliver JH 3rd, Federle MP. Spectrum of imaging findings of the liver in end-stage cirrhosis: part II, focal abnormalities. AJR Am J Roentgenol. Nov 1999;173(5):1185-92. [Medline][Full Text].

  3. Mergo PJ, Ros PR. Benign lesions of the liver. Radiol Clin North Am. Mar 1998;36(2):319-31. [Medline].

  4. Vilgrain V, Boulos L, Vullierme MP, et al. Imaging of atypical hemangiomas of the liver with pathologic correlation. Radiographics. Mar-Apr 2000;20(2):379-97. [Medline][Full Text].

  5. Yang DM, Yoon MH, Kim HS, Kim HS, Chung JW. Capsular retraction in hepatic giant hemangioma: CT and MR features. Abdom Imaging. Jan-Feb 2001;26(1):36-8. [Medline].

  6. Cappellani A, Zanghì A, Di Vita M, et al. Spontaneous rupture of a giant hemangioma of the liver. Ann Ital Chir. May-Jun 2000;71(3):379-83. [Medline].

  7. Bioulac-Sage P, Laumonier H, Laurent C, Blanc JF, Balabaud C. Benign and malignant vascular tumors of the liver in adults. Semin Liver Dis. Aug 2008;28(3):302-14. [Medline].

  8. Belli G, D'Agostino A, Fantini C, Cioffi L, Belli A, Limongelli P, et al. Surgical treatment of giant liver hemangiomas by enucleation using an ultrasonically activated device (USAD). Hepatogastroenterology. Jan-Feb 2009;56(89):236-9. [Medline].

  9. Kobayashi S, Maruyama H, Okugawa H, Yoshizumi H, Matsutani S, Ebara M, et al. Contrast-enhanced US with Levovist for the diagnosis of hepatic hemangioma: time-related changes of enhancement appearance and the hemodynamic background. Hepatogastroenterology. Jul-Aug 2008;55(85):1222-8. [Medline].

  10. Nghiem HV, Bogost GA, Ryan JA, et al. Cavernous hemangiomas of the liver: enlargement over time. AJR Am J Roentgenol. Jul 1997;169(1):137-40. [Medline][Full Text].

  11. Brancatelli G, Federle MP, Blachar A, Grazioli L. Hemangioma in the cirrhotic liver: diagnosis and natural history. Radiology. Apr 2001;219(1):69-74. [Medline][Full Text].

  12. Malagari K, Alexopoulou E, Dourakis S, et al. Transarterial embolization of giant liver hemangiomas associated with Kasabach-Merritt syndrome: a case report. Acta Radiol. Jul 2007;48(6):608-12. [Medline].

  13. Tran-Minh VA, Gindre T, Pracros JP, et al. Volvulus of a pedunculated hemangioma of the liver [letter]. AJR Am J Roentgenol. Apr 1991;156(4):866-7. [Medline].

  14. Hanazaki K, Koide N, Kajikawa S, et al. Cavernous hemangioma of the liver with giant cyst formation: degeneration by apoptosis?. J Gastroenterol Hepatol. Mar 2001;16(3):352-5. [Medline].

  15. Pol B, Disdier P, Le Treut YP, et al. Inflammatory process complicating giant hemangioma of the liver: report of three cases. Liver Transpl Surg. May 1998;4(3):204-7. [Medline].

  16. Mitsudo K, Watanabe Y, Saga T, et al. Nonenhanced hepatic cavernous hemangioma with multiple calcifications: CT and pathologic correlation. Abdom Imaging. Sep-Oct 1995;20(5):459-61. [Medline].

  17. Matsushita M, Takehara Y, Nasu H, et al. Atypically enhanced cavernous hemangiomas of the liver: centrifugal enhancement does not preclude the diagnosis of hepatic hemangioma. J Gastroenterol. Dec 2006;41(12):1227-30. [Medline].

  18. Mougiakakou SG, Valavanis IK, Nikita A, Nikita KS. Differential diagnosis of CT focal liver lesions using texture features, feature selection and ensemble driven classifiers. Artif Intell Med. Jul 9 2007;epub ahead of print. [Medline].

  19. Jeong MG, Yu JS, Kim KW. Hepatic cavernous hemangioma: temporal peritumoral enhancement during multiphase dynamic MR imaging. Radiology. Sep 2000;216(3):692-7. [Medline][Full Text].

  20. Shimada M, Matsumata T, Ikeda Y, et al. Multiple hepatic hemangiomas with significant arterioportal venous shunting. Cancer. Jan 15 1994;73(2):304-7. [Medline][Full Text].

  21. Kim S, Chung JJ, Kim MJ, et al. Atypical inside-out pattern of hepatic hemangiomas. AJR Am J Roentgenol. Jun 2000;174(6):1571-4. [Medline][Full Text].

  22. Leslie DF, Johnson CD, Johnson CM, Ilstrup DM, Harmsen WS. Distinction between cavernous hemangiomas of the liver and hepatic metastases on CT: value of contrast enhancement patterns. AJR Am J Roentgenol. Mar 1995;164(3):625-9. [Medline][Full Text].

  23. Quinn SF, Benjamin GG. Hepatic cavernous hemangiomas: simple diagnostic sign with dynamic bolus CT. Radiology. Feb 1992;182(2):545-8. [Medline][Full Text].

  24. McFarland EG, Mayo-Smith WW, Saini S, et al. Hepatic hemangiomas and malignant tumors: improved differentiation with heavily T2-weighted conventional spin-echo MR imaging. Radiology. Oct 1994;193(1):43-7. [Medline][Full Text].

  25. Demir OI, Obuz F, Sagol O, Dicle O. Contribution of diffusion-weighted MRI to the differential diagnosis of hepatic masses. Diagn Interv Radiol. Jun 2007;13(2):81-6. [Medline][Full Text].

  26. Tung GA, Vaccaro JP, Cronan JJ, Rogg JM. Cavernous hemangioma of the liver: pathologic correlation with high-field MR imaging. AJR Am J Roentgenol. May 1994;162(5):1113-7. [Medline][Full Text].

  27. Cheng HC, Tsai SH, Chiang JH, Chang CY. Hyalinized liver hemangioma mimicking malignant tumor at MR imaging [letter]. AJR Am J Roentgenol. Oct 1995;165(4):1016-7. [Medline].

  28. Soyer P, Bluemke DA, Fishman EK, Rymer R. Fluid-fluid levels within focal hepatic lesions: imaging appearance and etiology. Abdom Imaging. Mar-Apr 1998;23(2):161-5. [Medline].

  29. McArdle CR. Ultrasonic appearances of a hepatic hemangioma. J Clin Ultrasound. Apr 1978;6(2):124. [Medline].

  30. Taboury J, Porcel A, Tubiana JM, Monnier JP. Cavernous hemangiomas of the liver studied by ultrasound. Enhancement posterior to a hyperechoic mass as a sign of hypervascularity. Radiology. Dec 1983;149(3):781-5. [Medline][Full Text].

  31. Marsh JI, Gibney RG, Li DK. Hepatic hemangioma in the presence of fatty infiltration: an atypical sonographic appearance. Gastrointest Radiol. 1989;14(3):262-4. [Medline].

  32. Perkins AB, Imam K, Smith WJ, Cronan JJ. Color and power Doppler sonography of liver hemangiomas: a dream unfulfilled?. J Clin Ultrasound. May 2000;28(4):159-65. [Medline].

  33. Tak WY, Park SY, Jeon SW, et al. Ultrasonography-guided percutaneous radiofrequency ablation for treatment of a huge symptomatic hepatic cavernous hemangioma. J Clin Gastroenterol. Feb 2006;40(2):167-70. [Medline].

  34. el-Desouki M, Mohamadiyeh M, al-Rashed R, Othman S, al-Mofleh I. Features of hepatic cavernous hemangioma on planar and SPECT Tc-99m-labeled red blood cell scintigraphy. Clin Nucl Med. Aug 1999;24(8):583-9. [Medline].

  35. Kadir S. Angiography of the liver, spleen, and pancreas. Diagnostic Angiography. Philadelphia, Pa: WB Saunders Co; 1986:377-444.

  36. Hochwald SN, Blumgart LH. Giant hepatic hemangioma with Kasabach-Merritt syndrome: is the appropriate treatment enucleation or liver transplantation?. HPB Surg. Aug 2000;11(6):413-9. [Medline].

  37. Gedaly R, Pomposelli JJ, Pomfret EA, Lewis WD, Jenkins RL. Cavernous hemangioma of the liver: anatomic resection vs. enucleation. Arch Surg. Apr 1999;134(4):407-11. [Medline][Full Text].

  38. Hinshaw JL, Laeseke PJ, Weber SM, Lee FT Jr. Multiple-electrode radiofrequency ablation of symptomatic hepatic cavernous hemangioma. AJR Am J Roentgenol. Sep 2007;189(3):W146-9. [Medline].

  39. Ibrahim S, Chen CL, Wang SH, et al. Liver resection for benign liver tumors: indications and outcome. Am J Surg. Jan 2007;193(1):5-9. [Medline].

  40. Singh RK, Kapoor S, Sahni P, Chattopadhyay TK. Giant haemangioma of the liver: is enucleation better than resection?. Ann R Coll Surg Engl. Jul 2007;89(5):490-3. [Medline].

  41. Graham E, Cohen AW, Soulen M, Faye R. Symptomatic liver hemangioma with intra-tumor hemorrhage treated by angiography and embolization during pregnancy. Obstet Gynecol. May 1993;81(5 pt 2):813-6. [Medline].

  42. Haratake J, Horie A, Nagafuchi Y. Hyalinized hemangioma of the liver. Am J Gastroenterol. Feb 1992;87(2):234-6. [Medline].

  43. Nakaizumi A, Iishi H, Yamamoto R, et al. Diagnosis of hepatic cavernous hemangioma by fine needle aspiration biopsy under ultrasonic guidance. Gastrointest Radiol. 1990;15(1):39-42. [Medline].

Further Reading

Related eMedicine topics

Hemangiomas, Hepatic


Hemangioma, Cavernous

Kasabach-Merritt Syndrome (Hematology)

Kasabach-Merritt Syndrome (Pediatrics)

Budd-Chiari Syndrome

Clinical guidelines

AASLD practice guidelines: evaluation of the patient for liver transplantation. American Association for the Study of Liver Diseases - Private Nonprofit Research Organization.  2000 Jan (revised 2005 Jun).  26 pages.  NGC:004333

ACR Appropriateness Criteria® liver lesion characterization. American College of Radiology - Medical Specialty Society.  1998 (revised 2006).  7 pages.  NGC:005115

Surgery for hepatic colorectal metastases. Society for Surgery of the Alimentary Tract, Inc - Medical Specialty Society.  2004 May 15.  3 pages.  NGC:003837

Clinical trials

Incidence of Hepatic Hemangiomatosis in Patients With Cutaneous Hemangiomas

A Comparison of Contrast Enhanced Ultrasound (CEUS) and Contrast Enhanced Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) for Characterization of Focal Liver Masses

Keywords

cavernous hemangioma of liver, hepatic cavernous hemangioma, hepatic hemangioma, hemangioma of the liver, giant hemangioma of the liver, primary liver tumor, focal nodular hyperplasia, Kasabach-Merritt syndrome

Contributor Information and Disclosures

Author

Srinivasa R Prasad, MD,, Professor, Department of Radiology and Section Chief, Division of Abdominal Imaging, University of Texas Health Science Center at San Antonio
Srinivasa R Prasad, MD, is a member of the following medical societies: American Roentgen Ray Society, Radiological Society of North America, and Society of Uroradiology
Disclosure: Nothing to disclose.

Coauthor(s)

Dushyant Sahani, MD, Clinical Instructor of Abdominal Radiology and Intervention, Harvard Medical School; Assistant Radiologist, Department of Abdominal Imaging and Intervention, Massachusetts General Hospital
Disclosure: Nothing to disclose.

Sanjay Saini, MD, Associate Professor, Department of Radiology, Harvard Medical School; Vice Chairman, Department of Radiology, Health System Affairs, Massachusetts General Hospital
Sanjay Saini, MD is a member of the following medical societies: American College of Radiology, American Roentgen Ray Society, New England Roentgen Ray Society, and Radiological Society of North America
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

Udo P Schmiedl, MD, PhD, Clinical Professor, Department of Radiology, University of Washington; Consulting Staff, Swedish Medical Center, University of Washington Medical Center, Seattle Radiologists
Udo P Schmiedl, MD, PhD is a member of the following medical societies: American College of Radiology and Radiological Society of North America
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

John Karani, MBBS, FRCR, Clinical Director of Radiology and Consultant Radiologist, Department of Radiology, King's College Hospital, London
John Karani, MBBS, FRCR is a member of the following medical societies: British Institute of Radiology, British Society of Interventional Radiology, Cardiovascular and Interventional Radiological Society of Europe, European Society of Gastrointestinal and Abdominal Radiology, European Society of Radiology, Radiological Society of North America, and Royal College of Radiologists
Disclosure: Nothing to disclose.

 
 
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