Definition of Hepatic hemangioma:

A hepatic hemangioma is a noncancerous liver tumor made of widened (dilated) blood vessels.

Causes, incidence, and risk factors:

A hepatic hemangioma is the most common noncancerous tumor of the liver. It is believed to be a birth defect.

Hepatic hemangiomas can occur at any time, but are most common in people in their 30s - 50s. Women are affected more often than men, and usually have bigger tumors than men.

Babies may develop a type of hepatic hemangioma called benign infantile hemangioendothelioma (also called multinodular hepatic hemangiomatosis). This rare, noncancerous tumor has been linked to high rates of heart failure and death in infants. Infants are usually diagnosed by the time they are 6 months old.

Symptoms:

Some hemangiomas may cause bleeding or interfere with organ function, depending on their location. Most cavernous hemangiomas do not produce symptoms. In rare cases, a cavernous hemangioma may rupture.

Signs and tests:

Hepatic hemangioma is usually not discovered until medical pictures are taken of the liver for some other reason. If a cavernous hemangioma ruptures, the only sign may be an enlarged liver.

Babies with benign infantile hemangioendothelioma may have:

• A growth in the abdomen
• Anemia
• Signs of heart failure

The following tests may be performed:

• Blood tests
• CT scan of the liver
• Hepatic angiogram
• MRI
• Single-photon emission computed tomography (SPECT)
• Ultrasound of the abdomen

Treatment:

Most cavernous hepatic hemangiomas are treated only if there is persistent pain.

Treatment for infantile hemangioendothelioma depends on the child's growth and development. The following treatments may be needed:

• Inserting a material in a blood vessel of the liver to block it (embolization)
• Tying off (ligation) a liver artery
• Medications for heart failure
• Surgery to remove the tumor

Expectations (prognosis):

In infants whose tumor is only in one lobe of the liver, surgery is a cure, even if the child has heart failure.

Complications:

Pregnancy and estrogen-based medications can cause cavernous hemangiomas to grow.