The spontaneous rupture of a hepatic hemangioma is to be considered an exceptional event. Preventive surgery should be considered only for lesions of at least 11-cm size in special cohorts of patients.
Bleeding from the malformed blood vessels in the tumor into your abdominal cavity. Degeneration inside the tumor, such as blood clotting, scarring or calcium deposits. Direct trauma to the liver or severe strain can very rarely cause rupture of the tumor and internal bleeding (hemorrhage). This would be an emergency.
Hemangiomas are common benign tumors of the liver. Spontaneous rupture is a rare complication, occurring most commonly in giant hemangiomas. Rupture of a hemangioma with hemoperitoneum is a serious development and can be fatal if not managed promptly.
Your doctor might call it a hepatic hemangioma. The hemangioma, or tumor, is a tangle of blood vessels. It's the most common noncancerous growth in the liver. It's rarely serious and doesn't turn into liver cancer even when you don't treat it.
Most liver hemangiomas don't need any treatment. If the mass is larger than 5 centimeters, your doctor may schedule follow-up exams once or twice a year. Doctors will want to make sure that the tumor is not: In danger of rupture.
Although the overall rate of growth is slow, hemangiomas that exhibit growth do so at a modest rate (2 mm/y in linear dimension and 17.4% per year in volume). Further research is needed to determine how patients with more rapidly growing hemangiomas should be treated.
Surgical haemostatic methods such as packing, hepatic artery ligation and hepatic suture may be helpful to contain the bleeding in cases of ruptured hemangioma[8]. Surgical resection and enucleation are considered the treatments of choice.
Symptoms of a hemangioma are: A red to reddish-purple, raised growth on the skin. A massive, raised, bluish lump with visible blood vessels.
The indications for surgical resection are progressive abdominal pain in combination with size >5 cm. Observation is justified in patients with minimal or no symptoms, even in patients with giant hemangiomas.
The primary tumor and liver lesions both shrank with systemic therapy, potentially from the effect of bleomycin. Chemoresponsive hepatic hemangiomas can mimic the response of liver metastases to therapy, making the ability to distinguish between the 2 difficult.
Conclusions and Relevance Nearly 40% of hepatic hemangiomas grow over time. Although the overall rate of growth is slow, hemangiomas that exhibit growth do so at a modest rate (2 mm/y in linear dimension and 17.4% per year in volume).
No special dietary management is required, and no restriction of physical activity is indicated for most patients with hepatic hemangiomas. Patients with large hemangiomas may need to be instructed to avoid trauma to the right upper abdominal quadrant.
While hemangioma liver lesions themselves do not pose a threat, they do present a diagnostic challenge. Hemangiomas share similar characteristics to other liver lesions, and are commonly mistaken for malignant hyper vascular tumors of the liver, such as hepatoma (hepatocellular carcinoma) and fibrolamellar carcinoma.
Hepatic hemangioma (HH) is the most common benign liver tumor and it is usually found incidentally during radiological studies. This tumor arises from a vascular malformation; however, the pathophysiology has not been clearly elucidated. Symptoms usually correlate with the size and location of the tumor.
By nature, hepatic cyst contains fluid with protein but hepatic hemangioma contains vascular structures with tortuous and variation in sizes. Most of these conditions are free of symptom, except for some occasions; hemangioma may occur rupture causing internal hemorrhage.
Giant liver hemangiomas are defined by a diameter larger than 5 cm. In patients with a giant liver hemangioma, observation is justified in the absence of symptoms. Surgical resection is indicated in patients with abdominal (mechanical) complaints or complications, or when diagnosis remains inconclusive.
Since most hemangiomas go away on their own, doctors may not treat them when they first appear, unless they grow quickly, block vision, block airways or turn into wounds (ulcerate).
Most hemangiomas occur on the surface of the skin or just beneath it. They often develop on the face and neck, and can vary greatly in color, shape, and size. Because hemangiomas very rarely become cancerous, most do not require any medical treatment.
Hepatic hemangioma, a benign liver tumor, can rarely spontaneously rupture and hemorrhage, which is then associated with significant mortality. The diagnosis of internal hemorrhage is challenging and the management is disputed.
Aggressive vertebral hemangiomata are a rare form of vertebral hemangiomata where significant vertebral expansion, extra-osseous component with epidural extension, disturbance of blood flow, and occasionally compression fractures can be present causing spinal cord and/or nerve root compression 1,2.
Surgery is an option for removing a haemangioma but this depends on its size and location. Generally, surgery is suggested for 'functional' reasons, for instance, if a haemangioma is interfering with breathing or feeding. The surgeon will remove the haemangioma tissue and join the healthy skin together.
Typical hemangiomas, the so-called capillary hemangiomas, range from a few mm to 3 cm, do not increase in size over time and therefore are unlikely to generate future symptomatology. Small (mm-3 cm) and medium (3 cm-10 cm) hemangiomas are well-defined lesions, requiring no active treatment beside regular follow-ups.
Conclusion. Many symptoms in hepatic hemangioma are attributable to accompanying GI diseases. Patients with a single giant lesion are more likely to have persistent pain, and single lesions are more likely to grow in size.
For patients of ≥50 years, liver haemangiomas may grow slowly or stop growing, and surgical treatment may be unnecessary if no complications are caused by the tumour.