Effectiveness of Sorafenib in Hepatic Hemangioma.

Abstract

Hemangiomas are the most common benign tumors of the liver, with a frequency of 0.4% to 7.3%.1 Small liver hemangiomas (< 4 cm) are generally asymptomatic and can be observed without any chance of malignant transformation or complications. Hemangiomas are defined as giant if their size exceeds 4 cm.2 The most common site is the right lobe of the liver (subcapsular region). Small, asymptomatic hemangiomas do not show changes during long-term follow-up; hence they can be observed without any treatment.3 Giant liver hemangiomas are symptomatic and patients present with mild pain, abdominal mass, abdominal fullness and rarely with jaundice, consumptive coagulopathy (Kasabach-Merritt syndrome), or intra-abdominal bleeding as the result of rupture. Congestive heart failure and intraperitoneal bleeding can sometimes be fatal.4 Surgical resection is the only treatment option for symptomatic hemangiomas. Diagnosis is not easy to obtain because percutaneous biopsy is risky and the role of other treatment options such as steroids, hepatic artery ligation, and radiotherapy is controversial.5 Herein, we report an unusual case of a giant symptomatic hepatic hemangioma, which was initially diagnosed as an inoperable hepatocellular carcinoma (HCC) and treated with an oral tyrosine kinase inhibitor (ie, sorafenib).