Abstract
Giant hepatic hemangioma is a benign liver condition that may be treated using surgery. We studied the digital subtraction angiographic (DSA) characteristics of giant hepatic hemangioma, and the effectiveness of transcatheter arterial embolization (TAE) alone for its treatment. This was a retrospective study of 27 patients diagnosed with giant hepatic hemangioma and treated with TAE alone (using lipiodol mixed with pingyangmycin) at the Division of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University, between January 2010 and March 2013. The feeding arteries were identified using DSA. All patients were followed up for between three weeks and 12 months. Changes in tumor diameter and symptoms were observed. The 27 patients included had giant hepatic hemangiomas ranging from 5.3 to 24.5 cm (mean, 11.24±5.08 cm) in the right (n = 13), left (n = 1) or both (n = 13) lobes. Preoperative hepatic angiography showed multiple abnormal vascular lakes in the early phase, known as the “early leaving but late returning, hanging nut on a twig” sign. On the day after TAE, hepatic transaminase levels were increased (ALT: 22.69±17.95 to 94.88±210.32 U/L; ALT: 24.00±12.37 to 99.70±211.54 U/L; both P<0.05), but not total bilirubin. Six patients complained of abdominal pain, and 12 experienced transient fever. In the months after TAE, tumor size decreased (baseline: 11.24±5.08; 3 months: 8.95±4.33; 6 months: 7.60±3.90 cm; P<0.05), and the patients’ condition improved. These results indicated that TAE was effective and safe for treating giant hepatic hemangioma. TAE may be a useful alternative to surgery for the treatment of hepatic hemangioma.
Highlights
Hepatic hemangiomas are the most common benign tumor of the liver, accounting for 0.4–7.3% of all space-occupying hepatic lesions [1,2]
The aim of the present study was to assess the characteristics and outcomes of patients diagnosed with giant hepatic hemangioma and treated with transcatheter arterial embolization (TAE) only
Hepatic hemangiomas were located in the right lobe in 13 cases, in the left lobe in one case, and in both lobes in 13 cases
Summary
Hepatic hemangiomas are the most common benign tumor of the liver, accounting for 0.4–7.3% of all space-occupying hepatic lesions [1,2]. These lesions are more common in the elderly and in female patients (female:male ratio of 3:1) [1,3,4]. Hepatic hemangiomas larger than 4 cm are considered as giant hepatic hemangiomas [5,6]. Their pathogenesis is ill known, but many. Giant hepatic hemangiomas are more likely to cause symptoms than their smaller counterparts [14]
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