Radiotherapy for Large Liver Hemangioma: Report on Four Cases and Review of Literature

Abstract

Background: Hemangioma is the most common benign liver tumor, and mostly asymptomatic. For symptomatic hemangioma, surgical resection is the most common treatment. In unresectable hemangiomas, one of the alternative managements is radiotherapy, a relatively uncommon choice compared to transcatheter arterial embolization. We present our experience of four cases of liver hemangioma treated with fractionated radiotherapy and reviewed the literatures. Case Presentation: A total of four female patients, aged between 50 to 61 years, were retrospectively analyzed. They presented with symptoms of right upper quadrant pain and abdominal fullness. One patient had recurrent liver hemangioma years after liver resection. The other three received transcatheter arterial embolization to hemangioma with limited improvement in symptoms. All patients received radiotherapy with a total dose of 50-59.4 Gy in 20-33 fractions over a 4-7 week period. At the latest follow-up, the regression rate for these liver hemangiomas was 80.8% to 98.0% without radiation-associated adverse effects and the patients remained symptom-free. Conclusions: Radiotherapy is a feasible treatment for symptomatic liver hemangioma with good outcome.