Abstract

Introduction: Hepatic hemangiomas are benign liver tumors comprising clusters of blood-filled cavities, lined by endothelial cells, and supplied by the hepatic artery. The vast majority of hepatic hemangiomas (HH) are asymptomatic, often discovered incidentally during imaging studies for unrelated pathologies. Case Report: We present the clinical case of a 72-year-old patient admitted to our department due to a suspicious mass that emerged in the right hypochondrium a few months earlier. Laboratory studies were within normal limits, and diagnostic findings supported hepatic hemangiomatosis. Therapeutic abstention (with symptomatic treatment and close monitoring) was recommended. Discussion: Diffuse hepatic hemangiomatosis (DHH) is rare with an unclear etiology. In many cases, HH are small and asymptomatic at diagnosis with a stable progression. Asymptomatic patients typically undergo bservation with long-term follow-up, and imaging is generally unnecessary for lesions smaller than 5 cm, unless there is rapid growth or diagnostic uncertainty. Surgical resection may be considered for symptomatic patients or those with hemangiomas causing mass effects, after excluding other causes of pain. Conclusion: Ensuring an accurate diagnosis of hepatic hemangiomas is essential to differentiate them from other focal hepatic lesions, considering the possibility of coexisting diagnoses. While the majority of cases are asymptomatic and non-progressive, a subset may exhibit rapid growth or complications, requiring specific therapeutic approaches.

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