Abstract
IntroductionLiver cavernous hemangioma is the most common noncystic hepatic lesion, and a hemangioma that undergoes degeneration and fibrous replacement is called a hepatic sclerosed hemangioma.Case presentationA 63-year-old Japanese man was admitted for detailed investigation of a liver tumor. Tumor markers carcinoembryonic antigen, alpha-fetoprotein, and CA19-9 levels in the peripheral blood were not elevated at any time. Plain computed tomography showed an approximately 1.5cm low density mass in the periphery of segment 8, which was marginally enhanced on contrast-enhanced dynamic computed tomography. On magnetic resonance imaging, the tumor was hypointense on T1-weighted image and hyperintense on T2-weighted image. The tumor was suspected to be an atypical hemangioma, metastatic, hepatocellular carcinoma, or cholangiocellular carcinoma. Segmental hepatectomy was performed. Histological examination of the resected tumor specimen revealed a sclerosed hemangioma with marked hyalinization and sparse stromal fibrosis. Immunochemically, the tumor cells were positive for CD34 and alpha smooth muscle actin. Electron microscopically, the residual hemangioma consisted of numerous caveolae and vesicles in endothelial cells in irregular shapes and sizes. Immunostaining for caveolin-1 showed decreased or no caveolin-1 reactivity in the hyalinized lesions of the sclerosed hemangioma, but abundant caveolin-1 reactivity in the residual cavernous hemangioma. Of interest, computed tomography images of the tumor obtained 10 years earlier at our hospital depicted a 3cm typical cavernous hemangioma.ConclusionsHepatic sclerosed hemangioma is a rare condition. Comparison of radiological findings of the lesion over a period of 10 years was valuable in providing insight for the evolutional process from liver cavernous hemangioma to hepatic sclerosed hemangioma.
Highlights
Liver cavernous hemangioma is the most common noncystic hepatic lesion, and a hemangioma that undergoes degeneration and fibrous replacement is called a hepatic sclerosed hemangioma.Case presentation: A 63-year-old Japanese man was admitted for detailed investigation of a liver tumor
Comparison of radiological findings of the lesion over a period of 10 years was valuable in providing insight for the evolutional process from liver cavernous hemangioma to hepatic sclerosed hemangioma
Radiological images obtained 10 years earlier were available for comparison, which were valuable in providing insights to the evolutional process from Liver cavernous hemangioma (LCH) to hepatic sclerosed hemangioma (HSH)
Summary
Consent Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Competing interests The authors declare that they have no competing interests. YS and MW collected the references and contributed to the writing. HYa interpreted the liver histology and contributed to the writing. Author details 1Department of Internal Medicine, Kitasato University Medical Center, 6-100 Arai, Kitamoto-shi, Saitama 364-8501, Japan. Author details 1Department of Internal Medicine, Kitasato University Medical Center, 6-100 Arai, Kitamoto-shi, Saitama 364-8501, Japan. 2Department of Surgery, Kitasato University Medical Center, Saitama, Japan. 3Department of Radiology, Kitasato University Medical Center, Saitama, Japan. 4Department of Pathology, Kitasato University Medical Center, Saitama, Japan. 5Organized Center of Clinical Medicine, International University of Health and Welfare, Tokyo, Japan
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