Keywords:
Abdomen, Liver, CT, MR, Contrast agent-intravenous, Haemangioma, Cirrhosis
Authors:
J. CHOI, J.-S. Yu, E.-S. Cho, J. H. Kim, J.-J. Chung; SEOUL/KR
DOI:
10.1594/ecr2018/C-0753
Aims and objectives
Hepatic hemangioma is one of the most common benign lesions of the liver,
detected in 0.4–20% of cases in autopsy series [1,2].
It is usually asymptomatic and incidentally found in imaging studies performed for other causes,
and there has been no report of malignant transformation.
The natural history of hepatic hemangioma was recently reported considering the surgical management depending on the speed of tumor growth [3,4].
The studies found that nearly half of the hemangiomas increased in size by up to 2 mm/year during a mean follow-up period of 3.7 years [3],
and that the growth rate decreased rapidly when the diameter of the lesions became >10 cm or in patients older than 50 years during a median follow-up period of 4 years,
obviating the need for preventive treatment even in patients with large lesions [4].
Meanwhile,
several prior studies reported that hepatic hemangiomas tended to enlarge during pregnancy or estrogen treatment,
suggesting a role for female sex hormones in hemangioma growth [5,6].
On the other hand,
hepatic hemangiomas were previously reported to shrink in livers with a cirrhotic background with loss of typical imaging features [7-9].
However,
aside from the developmental background,
the causative factors of size changes of hepatic hemangiomas are still under debate.
In recent studies on the natural changes of hepatic hemangiomas,
clinical information was not thoroughly analyzed and the follow-up duration was limited [1,2].
Moreover,
there have been no data supporting the effects of causative factors inducing tumor growth or the development of hepatic hemangiomas in a large group of patients.
Therefore,
this study was conducted to investigate the long-term changes of hepatic hemangiomas during a follow-up period of >5 years,
and to determine the intrinsic or extrinsic determinants for the size changes of hepatic hemangiomas.